If a best effort at each of these three upper airway ‘lifelines’ is unsuccessful, then airway patency must be restored by initiating ‘CICO rescue’ (emergency front-of-neck access). The Vortex is based on the principle that there are three ‘non-surgical’ techniques to establish a patent airway: use of a face mask, a supraglottic airway, or an endotracheal tube. Familiarity is recognized as being important for a crisis management implementation tool to be effective The second assumption the Vortex makes is that teams have been trained in its use before the occurrence of an airway crisis. Given these prompts, preparatory activities should have provided clinicians with the basis to make a judgement on the best course of action to take in a given context and the technical skills for implementing it. The expectation is that the tool should prompt a clinical team with the options for airway management and facilitate shared situational awareness. The Vortex is not intended to teach clinicians or compensate for deficiencies in training, experience, consultation, or planning. As such, its role is to prompt implementation of previously learned knowledge and skills. The first is that the tool will be used by clinicians who are already competent to perform advanced airway management independently. To maintain such a design, the Vortex makes two assumptions. Experimental evidence is required to establish this. The Vortex contains many of the recognized features of an ideal cognitive tool and may be effective in reducing implementation errors in emergency airway management. This makes the same tool suitable for use by emergency physicians, intensivists, paramedical staff, and anaesthetists. Unlike the major algorithms, which are context specific, the Vortex is flexible enough for the same tool to be applied to any circumstance in which airway management takes place, independent of context, patient type, or the intended airway device. The Vortex is a novel, simple, and predominantly visually based cognitive aid, which has been specifically designed to be used in real time during airway emergencies to support team function and target recognized failings in airway crisis management. This can produce tools which may be not only ineffective but actively disruptive to team function in an emergency. Many of the major airway guidelines do not specify whether they are intended to be used during preparation or implementation and may not take the context for use into account in their design. Effective design of resources that provide guidance on management requires consideration of the context in which they are to be used. Special Issue on Memory and Awareness in Anesthesia (PDF)įactors influencing performance during emergency airway management can be broadly divided into issues with preparation and those with implementation.Special Issue on Mass Casualty Medicine and Anaesthesia: Science and Clinical Practice (JPG).Special Issue on Thoracic Anaesthesia and Respiratory Physiology (PDF).Hong Kong College of Anaesthesiologists.College of Anaesthesiologists of Ireland. Memory, Awareness and Anaesthesia 2022 Special Collection.COVID-19 and the Anaesthetist: A Special Series.
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