Patient safety
network of Airway Leads across the UK, one of the recommendations from the 2011 study of complications in airway management mentioned earlier. The RCoA and DAS strongly endorse the recommendation that all anaesthetic departments appoint a designated Airway Lead.5
In my role as an Airway Lead in Sussex, I
have found it to be an invaluable opportunity to support colleagues in their ongoing education and skill development. Airway Leads play an important role in ensuring safe airway management in their departments and hospitals. That includes overseeing local airway training, both for anaesthetists and more widely, ensuring local policies are in place and that appropriate equipment is available. Airway Leads also liaise with colleagues in ICU and Emergency Departments to ensure consistency of standards and practice and oversee audits of airway assessment and adherence with guidelines. Personally, I have found this role to be incredibly rewarding – whether it’s helping a colleague refine a technique, organising simulation training, or advising on complex airway cases, the ability to contribute to patient safety and team confidence is highly fulfilling. If you are looking for support or resources, you can search the Airway Lead Database on the RCoA website to find your local lead.6
Knowing your kit Part of training must include familiarity with your hospital specific surroundings. As simple as it sounds, knowing where your difficult airway trolley (DAT) is located should not be taken as a given. If a team has been fortunate enough not to need the equipment for a period, and especially if there has been turnover in the team, not everyone may know where the kit is. Seconds can be precious in an emergency and your first resource in the case of difficult airway must be your difficult airways kit. The trolley itself should not only be fully
In an emergency situation, we need to implement a rehearsed action plan to ensure patient safety. This requires a well-prepared team who understand the individualised strategy in place, have undertaken the right training and communicate well.
stocked but organised in a sensible way. A common method is for the drawers to correspond to steps along airway management. The top-drawer containing kit for intubation, second for oxygenation (via a supraglottic airway device), third for facemask ventilation, fourth emergency invasive airway access (eFONA), and then perhaps a fifth draw for specialised airway equipment (for expert use only!) This method is not universal so it’s important to familiarise yourself with your
hospital’s organisation and to remember to do so for different surgical theatres if you travel.
Human factors Human factors is an evidence-based scientific discipline used in safety critical industries to improve safety and worker well-being. While planning and preparation is infinitely helpful the best laid plans can go astray. We must be able to meet the challenge in front of us, as a team. In an emergency, it’s important to have a hierarchy of controls, a system to fall back on when there is an emergency. DAS and the Association of Anaesthetists have published excellent guidance for clinicians, departments and hospitals on implementing human factors in anaesthesia.7
This guidance includes things
individual clinicians can do now, without asking for any permission, to help improve safety. A big part of human factors is creating a cohesive team. As I’ve already pointed out, continued training needs to be a priority for everyone but naturally there will be different levels of skills across the team. This may or may not correlate with job title or years of experience and it’s important to disregard our usual hierarchies if there is someone who can be reliably counted upon to perform a
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www.clinicalservicesjournal.com I May 2025
chanawit -
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Robert Kneschke -
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