Difficult Airway Response Team - What Are the Anesthesiologist’s Roles in Improving the Safety of Airway Management in Outside Operating Theaters?

Worsening respiratory symptoms are the leading cause of rapid response system(RRS)calls from wards. Many patients presenting these symptoms can only be treated with supplemental oxygen, but some require advanced airway management. Airway management in general wards is more difficult than in the oper...

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Published inNihon Rinshō Masui Gakkai shi Vol. 41; no. 3; pp. 247 - 255
Main Author NAKAGAWA, Masashi
Format Journal Article
LanguageEnglish
Japanese
Published THE JAPAN SOCIETY FOR CLINICAL ANESTHESIA 15.05.2021
Subjects
Online AccessGet full text
ISSN0285-4945
1349-9149
1349-9149
DOI10.2199/jjsca.41.247

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Abstract Worsening respiratory symptoms are the leading cause of rapid response system(RRS)calls from wards. Many patients presenting these symptoms can only be treated with supplemental oxygen, but some require advanced airway management. Airway management in general wards is more difficult than in the operating room because these rooms are small and dark, lack airway management tools, lack support from well-trained persons, and so on. As specialists in airway management, anesthesiologists are responsible for making airway management in these wards safer.At Johns Hopkins hospital, the Difficult Airway Response Team(DART)has been introduced to improve airway management safety in the ward. This is an ideal system for improving safety, but introducing it directly into our own medical system would be difficult. The DART system has three components: operations, safety, and education.Compared to operation center staff, general ward staff lack knowledge of the DAM algorithm and new airway management devices. When anesthesiologists work to secure airways in general wards, this gap in knowledge can make it difficult to manage airways smoothly. Anesthesiologists must provide education to help diminish this gap.
AbstractList Worsening respiratory symptoms are the leading cause of rapid response system(RRS)calls from wards. Many patients presenting these symptoms can only be treated with supplemental oxygen, but some require advanced airway management. Airway management in general wards is more difficult than in the operating room because these rooms are small and dark, lack airway management tools, lack support from well-trained persons, and so on. As specialists in airway management, anesthesiologists are responsible for making airway management in these wards safer.At Johns Hopkins hospital, the Difficult Airway Response Team(DART)has been introduced to improve airway management safety in the ward. This is an ideal system for improving safety, but introducing it directly into our own medical system would be difficult. The DART system has three components: operations, safety, and education.Compared to operation center staff, general ward staff lack knowledge of the DAM algorithm and new airway management devices. When anesthesiologists work to secure airways in general wards, this gap in knowledge can make it difficult to manage airways smoothly. Anesthesiologists must provide education to help diminish this gap.
Author NAKAGAWA, Masashi
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Cites_doi 10.1093/bja/aer059
10.1111/imj.13248
10.1016/j.ccc.2017.12.008
10.1007/s00540-014-1844-4
10.1016/j.bja.2017.10.021
10.1213/ANE.0000000000000691
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References 5) Mark LJ, Herzer KR, Cover R, et al.:Difficult airway response team:a novel quality improvement program for managing hospital-wide airway emergencies. Anesth Analg 121:127-139, 2015
1) White K, Scott IA, Bernard A, et al.:Patient characteristics, interventions and outcomes of 1151 rapid response team activations in a tertiary hospital:a prospective study. Intern Med J 46:1398-1406, 2016
2) Cook TM, Woodall N, Harper J, et al.:Major complications of airway management in the UK:results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 2:intensive care and emergency departments. Br J Anaesth 106:632-642, 2011
7) Japanese Society of Anesthesiologists:JSA airway management guideline 2014:to improve the safety of induction of anesthesia. J Anesth 28:482-493, 2014
4) Mark L, Lester L, Cover R, et al.:A Decade of Difficult Airway Response Team:Lessons Learned from a Hospital-Wide Difficult Airway Response Team Program. Crit Care Clin 34:239-251, 2018
6) 中川雅史,野村岳志,五十嵐寛ほか:Difficult Airway Management(DAM)第1回実践セミナーを実施して. 麻酔 54:557-562,2005
3) Higgs A, McGrath BA, Goddard C, et al.:Guidelines for the management of tracheal intubation in critically ill adults. Br J Anaesth 120:323-352, 2018
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References_xml – reference: 3) Higgs A, McGrath BA, Goddard C, et al.:Guidelines for the management of tracheal intubation in critically ill adults. Br J Anaesth 120:323-352, 2018
– reference: 2) Cook TM, Woodall N, Harper J, et al.:Major complications of airway management in the UK:results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 2:intensive care and emergency departments. Br J Anaesth 106:632-642, 2011
– reference: 6) 中川雅史,野村岳志,五十嵐寛ほか:Difficult Airway Management(DAM)第1回実践セミナーを実施して. 麻酔 54:557-562,2005
– reference: 4) Mark L, Lester L, Cover R, et al.:A Decade of Difficult Airway Response Team:Lessons Learned from a Hospital-Wide Difficult Airway Response Team Program. Crit Care Clin 34:239-251, 2018
– reference: 5) Mark LJ, Herzer KR, Cover R, et al.:Difficult airway response team:a novel quality improvement program for managing hospital-wide airway emergencies. Anesth Analg 121:127-139, 2015
– reference: 7) Japanese Society of Anesthesiologists:JSA airway management guideline 2014:to improve the safety of induction of anesthesia. J Anesth 28:482-493, 2014
– reference: 1) White K, Scott IA, Bernard A, et al.:Patient characteristics, interventions and outcomes of 1151 rapid response team activations in a tertiary hospital:a prospective study. Intern Med J 46:1398-1406, 2016
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Snippet Worsening respiratory symptoms are the leading cause of rapid response system(RRS)calls from wards. Many patients presenting these symptoms can only be...
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SubjectTerms DART
Non-technical skills
Safety management
Staff education
Technical skills
Title Difficult Airway Response Team - What Are the Anesthesiologist’s Roles in Improving the Safety of Airway Management in Outside Operating Theaters?
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