Structured Management Airway Response Team for Walsall Hospital Theatre Staff David Faulkner S.O.D.P. Theatres Elaine Bromiley DVD available to view via Youtube Copyright for S.M.A.R.T. owned by Difficult Airway Society - http://www.das.uk.com/

1. THE UNANTICIPATED
DIFFICULT AIRWAY
AND THE
INTRODUCTION OF
S.M.A.R.T
ROLES

2. WHAT IS S.M.A.R.T ABOUT
WHY DO WE NEED S.M.A.R.T
STANDARD SETTING FOR S.M.A.R.T
TRAINING NEEDS FOR S.M.A.R.T
PRESENTATION OBJECTIVES
TO DISCOVER

3. S.M.A.R.T
STRUCTURED
MANAGEMENT
AIRWAY
RESPONSE
TEAM

4. WHAT IS S.M.A.R.T
ABOUT
• This course was developed by the "Difficult Airway Society" DAS
designed to teach both technical and non-technical skills in
airway management.
• The course highlights behaviours and human factors when
dealing with an unanticipated difficult airway.
• Illustrates the need for shared information and structured
planning to reduce error.
• Provides structured guides to ensure coordinated leadership and
management during the difficult airway situation.

5. WHY DO WE NEED
S.M.A.R.T
•Human factors - Humans can be the strongest or
weakest part of a team. When dealing with a difficult
airway situation, HUMAN FACTORS can create.
LOSS OF SITUATIONAL AWARENESS
LOSS OF PERCEPTION AND COGNITION
FRAGMENTED TEAMWORK
LOSS OF AIRWAY CONTROL

6. DVD
Just a routine operation
Elaine Bromiley case

7. SETTING STANDARDS
Dedicated S.M.A.R.T
roles
Team Brief
Assign Designated Roles

8. 1st Anaesthetist
ODP / Anaesthetic Practitioner
Theatre Staff One
Theatre Staff Two
Support Worker

9. 1st ANAESTHETIST
• Highlights the trigger
response "Difficult Airway"
should the need arise to call
for help
• Shares information with team
members, assigns roles and
provides a structured brief
concerning anticipated and
unanticipated difficult airways
• In the "difficult airway"
situation, follows adult DAS
algorithm, creating structure
and teamwork in the
emergency setting.

10. ODP / ANAESTHETIC
Practitioner
• Follows the instructions given
by the anaesthetist during
the Team Brief
• In a "Difficult Airway"
situation, suggests the trigger
call is given
• Remains with Anaesthetist
and patient at all times
following the DAS role for
ODP / Anaesthetic
Practitioner

11. THEATRE STAFF
ONE• Follows the instructions
provided in the Team Brief
• In the "Difficult Airway"
situation, responds to the
trigger call "Difficult Airway",
presents to the intubating
area and performs allocated
role, completes paperwork,
documenting vital signs,
announcing time when
saturations fall below 90%
and verbalises from the
onset "time zero" stating time
then on every two minutes.

12. THEATRE STAFF
TWO
• Follows the instructions
provided in the Team Brief.
• In the "Difficult Airway"
situation, responds to the
trigger call by performing
allocated role, collects
difficult airway trolley and any
other stated equipment, fast
bleeps 2nd Anaesthetist and
surgical colleague and helps
ODP / Anaesthetic
Practitioner as requested

13. SUPPORT WORKER
• Follows the instructions
provided in the Team Brief.
• Responds to the trigger call
"Difficult Airway" by
immediately collecting the
Fibreoptic Laryngoscope
from its designated area.
• On return responds to any
other stated tasks
• This role has been
incorporated to this hospital
due to the remote location of
the fibreoptic laryngoscope.

14. DAS
UNANTICIPATED DIFFICULT AIRWAY
ALGORITHM

15. EQUIPMENT
STANDARDISATION
• A "Difficult Airway" trolley will
be situated in all Theatre
departments.
• The contents of the drawers
will be standardised following
the sequence A to D as
per DAS algorithm.
DIFFICULT AIRWAY
TROLLEY

16. EQUIPMENT
STANDARDISATION
• Allocated storage area in each
department with clear sign
recognition
• All grades of staff will be familiar
with its location.
• Daily checks will be completed,
including equipment and expiry
dates, in accordance to an
attached content list.
• An allocated person will check the
trolley and signature check list
completed.

17. TRAINING NEEDS
• Unanticipated difficult airway
training sessions.
• Simulations of "Difficult
Airway" situations.
• Training video's of available
intubation equipment.
It is our responsibility to ensure
that all staff are advised to the
location of the Difficult Airway
equipment

18. PRESENTATION
CONCLUSION
SMART
WHATS IS S.M.A.R.T ABOUT
The creation of structure, teamwork and
effective efficiency in an emergency situation.

19. WHY DO WE NEED
S.M.A.R.T
To overcome the negative effects that can occur
due to Human Factors
To ensure error avoidance
To ensure controlled standardised teamwork
and avoid crisis

20. HOW DO WE
ACHIEVE S.M.A.R.T
Standardisation of
equipment, its location and its use
Informed, educated staff
Efficient, effective TEAMWORK

21. THANK YOU FOR
LISTENING
DAVID FAULKNER
S.O.D.P