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  1. Article ; Online: Safe use of high flow nasal oxygen in apnoeic patients for laryngotracheal surgery: Adapting practice as technology evolves.

    Ward, Patrick A / Athanassoglou, Vassilis / McNarry, Alistair F

    European journal of anaesthesiology

    2023  Volume 40, Issue 11, Page(s) 801–804

    MeSH term(s) Humans ; Oxygen ; Apnea ; Airway Management ; Technology ; Oxygen Inhalation Therapy
    Chemical Substances Oxygen (S88TT14065)
    Language English
    Publishing date 2023-10-11
    Publishing country England
    Document type Journal Article ; Comment
    ZDB-ID 605770-6
    ISSN 1365-2346 ; 0265-0215
    ISSN (online) 1365-2346
    ISSN 0265-0215
    DOI 10.1097/EJA.0000000000001890
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    In stock of ZB MED Cologne/Königswinter

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  2. Article ; Online: Videolaryngoscopy in critical care and emergency locations: moving from debating benefit to implementation.

    Pass, Marc / Di Rollo, Nicola / McNarry, Alistair F

    British journal of anaesthesia

    2023  Volume 131, Issue 3, Page(s) 434–438

    Abstract: The recently published INTUBE study subanalysis and DEVICE trial findings both demonstrate a clear benefit of videolaryngoscopy over direct laryngoscopy in facilitating tracheal intubation of patients in the emergency department and ICU. We consider the ... ...

    Abstract The recently published INTUBE study subanalysis and DEVICE trial findings both demonstrate a clear benefit of videolaryngoscopy over direct laryngoscopy in facilitating tracheal intubation of patients in the emergency department and ICU. We consider the increasing evidence supporting the use of videolaryngoscopy, the possible reasons behind its relatively slow adoption into clinical practice, and the potential role of the hyperangulated videolaryngoscope blade. We discuss the significance of improved first-pass tracheal intubation success in reducing the overall risk of complications in critically ill patients. Additionally, we address the need for specific training in videolaryngoscopy in order to maximise patient benefit, and propose that adequate training and rehearsal opportunities in videolaryngoscopy can only be realised by widespread and regular use wherever the clinical setting.
    MeSH term(s) Humans ; Laryngoscopy ; Laryngoscopes ; Intubation, Intratracheal ; Critical Care ; Emergency Service, Hospital ; Video Recording
    Language English
    Publishing date 2023-07-26
    Publishing country England
    Document type Editorial ; Comment
    ZDB-ID 80074-0
    ISSN 1471-6771 ; 0007-0912
    ISSN (online) 1471-6771
    ISSN 0007-0912
    DOI 10.1016/j.bja.2023.06.057
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: New evidence to inform decisions and guidelines in difficult airway management.

    McNarry, Alistair F / Asai, Takashi

    British journal of anaesthesia

    2021  Volume 126, Issue 6, Page(s) 1094–1097

    MeSH term(s) Airway Management ; Computer Simulation ; Humans ; Laryngeal Masks
    Language English
    Publishing date 2021-04-06
    Publishing country England
    Document type Editorial ; Comment
    ZDB-ID 80074-0
    ISSN 1471-6771 ; 0007-0912
    ISSN (online) 1471-6771
    ISSN 0007-0912
    DOI 10.1016/j.bja.2021.03.003
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  4. Article ; Online: Practical strategies for delivering airway training in the COVID-19 era.

    Hickman, John / McNarry, Alistair F / Kelly, Fiona E

    British journal of anaesthesia

    2021  Volume 127, Issue 2, Page(s) 188–191

    Language English
    Publishing date 2021-05-14
    Publishing country England
    Document type Editorial
    ZDB-ID 80074-0
    ISSN 1471-6771 ; 0007-0912
    ISSN (online) 1471-6771
    ISSN 0007-0912
    DOI 10.1016/j.bja.2021.05.004
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  5. Article: Airway Management: The Current Role of Videolaryngoscopy.

    Saul, Sophie A / Ward, Patrick A / McNarry, Alistair F

    Journal of personalized medicine

    2023  Volume 13, Issue 9

    Abstract: Airway management is usually an uncomplicated and safe intervention; however, when problems arise with the primary airway technique, the clinical situation can rapidly deteriorate, resulting in significant patient harm. Videolaryngoscopy has been shown ... ...

    Abstract Airway management is usually an uncomplicated and safe intervention; however, when problems arise with the primary airway technique, the clinical situation can rapidly deteriorate, resulting in significant patient harm. Videolaryngoscopy has been shown to improve patient outcomes when compared with direct laryngoscopy, including improved first-pass success at tracheal intubation, reduced difficult laryngeal views, reduced oxygen desaturation, reduced airway trauma, and improved recognition of oesophageal intubation. The shared view that videolaryngoscopy affords may also facilitate superior teaching, training, and multidisciplinary team performance. As such, its recommended role in airway management has evolved from occasional use as a rescue device (when direct laryngoscopy fails) to a first-intention technique that should be incorporated into routine clinical practice, and this is reflected in recently updated guidelines from a number of international airway societies. However, currently, overall videolaryngoscopy usage is not commensurate with its now widespread availability. A number of factors exist that may be preventing its full adoption, including perceived financial costs, inadequacy of education and training, challenges in achieving deliverable decontamination processes, concerns over sustainability, fears over "de-skilling" at direct laryngoscopy, and perceived limitations of videolaryngoscopes. This article reviews the most up-to-date evidence supporting videolaryngoscopy, explores its current scope of utilisation (including specialist techniques), the potential barriers preventing its full adoption, and areas for future advancement and research.
    Language English
    Publishing date 2023-08-29
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2662248-8
    ISSN 2075-4426
    ISSN 2075-4426
    DOI 10.3390/jpm13091327
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  6. Article ; Online: Airway Management

    Sophie A. Saul / Patrick A. Ward / Alistair F. McNarry

    Journal of Personalized Medicine, Vol 13, Iss 1327, p

    The Current Role of Videolaryngoscopy

    2023  Volume 1327

    Abstract: Airway management is usually an uncomplicated and safe intervention; however, when problems arise with the primary airway technique, the clinical situation can rapidly deteriorate, resulting in significant patient harm. Videolaryngoscopy has been shown ... ...

    Abstract Airway management is usually an uncomplicated and safe intervention; however, when problems arise with the primary airway technique, the clinical situation can rapidly deteriorate, resulting in significant patient harm. Videolaryngoscopy has been shown to improve patient outcomes when compared with direct laryngoscopy, including improved first-pass success at tracheal intubation, reduced difficult laryngeal views, reduced oxygen desaturation, reduced airway trauma, and improved recognition of oesophageal intubation. The shared view that videolaryngoscopy affords may also facilitate superior teaching, training, and multidisciplinary team performance. As such, its recommended role in airway management has evolved from occasional use as a rescue device (when direct laryngoscopy fails) to a first-intention technique that should be incorporated into routine clinical practice, and this is reflected in recently updated guidelines from a number of international airway societies. However, currently, overall videolaryngoscopy usage is not commensurate with its now widespread availability. A number of factors exist that may be preventing its full adoption, including perceived financial costs, inadequacy of education and training, challenges in achieving deliverable decontamination processes, concerns over sustainability, fears over “de-skilling” at direct laryngoscopy, and perceived limitations of videolaryngoscopes. This article reviews the most up-to-date evidence supporting videolaryngoscopy, explores its current scope of utilisation (including specialist techniques), the potential barriers preventing its full adoption, and areas for future advancement and research.
    Keywords videolaryngoscopy ; videolaryngoscope ; laryngoscopy ; airway management ; Medicine ; R
    Language English
    Publishing date 2023-08-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  7. Article ; Online: Optiflow™ Switch: A design modification that can extend safe apnoeic oxygenation (THRIVE) time for tubeless airway surgery. A case series.

    Thompson, Louise / Ward, Patrick / Nixon, Iain J / Milligan, Pamela / McNarry, Alistair F

    Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery

    2022  

    Language English
    Publishing date 2022-10-03
    Publishing country England
    Document type Journal Article
    ZDB-ID 2205891-6
    ISSN 1749-4486 ; 1749-4478 ; 0307-7772 ; 1365-2273
    ISSN (online) 1749-4486
    ISSN 1749-4478 ; 0307-7772 ; 1365-2273
    DOI 10.1111/coa.13986
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    Zs.A 1309: Show issues Location:
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  8. Article: Airway Leads and Airway Response Teams: Improving Delivery of Safer Airway Management?

    Smith, Carolyn / McNarry, Alistair F

    Current anesthesiology reports

    2020  Volume 10, Issue 4, Page(s) 370–377

    Abstract: Purpose of review: Airway management remains a source of significant morbidity and mortality. This review considers recent summaries of complications and looks toward strategies to improve practice using a coordinated approach.: Recent findings: A ... ...

    Abstract Purpose of review: Airway management remains a source of significant morbidity and mortality. This review considers recent summaries of complications and looks toward strategies to improve practice using a coordinated approach.
    Recent findings: A safety gap can exist between national recommendations and local practice. A lack of attention to end tidal carbon dioxide has repeatedly contributed to airway mismanagement. Clinicians must be trained in newer airway devices (videolaryngoscopes or supraglottic airways) to use them effectively. Time must be found to teach rarely performed skills (e.g., front-of-neck access). Both larger and smaller hospitals have benefitted from an airway lead or response team, coordinating education programs, ensuring the adoption of guidelines, standardizing equipment, and recognizing the role of human factors and ergonomics.
    Summary: Even in the twenty-first century, the incidence of airway-related morbidity and mortality can be reduced, by an institutionally supported, coordinated approach to the whole process of airway care.
    Keywords covid19
    Language English
    Publishing date 2020-07-20
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2057373-X
    ISSN 2167-6275 ; 1523-3855
    ISSN (online) 2167-6275
    ISSN 1523-3855
    DOI 10.1007/s40140-020-00404-7
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    Zs.A 5532: Show issues Location:
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  9. Article ; Online: Simple steps towards improving safety in obstetric airway management: A quality improvement project.

    Critchley, Julia D / Ferguson, Cassandra / Kidd, Emily / Ward, Patrick / McNarry, Alistair F / Theodosiou, Catherine A / Alexander, Nicki

    European journal of anaesthesiology

    2023  Volume 40, Issue 11, Page(s) 826–832

    Abstract: Background: Guidelines from the Obstetric Anaesthetists' Association and Difficult Airway Society state that 'a videolaryngoscope should be immediately available for all obstetric general anaesthetics'.: Objective: To report the incidence of ... ...

    Abstract Background: Guidelines from the Obstetric Anaesthetists' Association and Difficult Airway Society state that 'a videolaryngoscope should be immediately available for all obstetric general anaesthetics'.
    Objective: To report the incidence of videolaryngoscopy use, and other airway management safety interventions, in an obstetric population before and after various quality improvement interventions.
    Design: Prospective data collection was undertaken over 18 months, divided into three separate 6-month periods: June to November 2019; March to August 2021; January to June 2022. These periods relate to evaluation of specific quality improvement interventions.
    Setting: The project was carried out in a large tertiary referral obstetric unit.
    Patients: We identified 401 pregnant women (> 20 weeks' gestation) and postnatal women (up to 48 h post delivery) undergoing an obstetric surgical procedure under general anaesthesia.
    Interventions: To standardise practice, an intubation checklist was introduced in December 2020 and multidisciplinary staff training in August 2021.
    Main outcome measures: Primary outcome measures were use of a Macintosh-style videolaryngoscope and tracheal intubation success. Secondary outcome measures were use of an intubation checklist; low flow nasal oxygen; and ramped patient positioning.
    Results: Data from 334 tracheal intubations (83.3% of cases) were recorded. Videolaryngoscope use increased from 60% in 2019, to 88% in 2021, to 94% in 2022. Tracheal intubation was successful in all patients, with 94% first pass success overall and only 0.9% requiring three attempts. Use of secondary outcome measures also increased: low flow nasal oxygen from 48% in 2019 to 90% in 2022; ramped positioning from 95% in 2021 to 97% in 2022; and checklist use from 63% in 2021 to 92% in 2022.
    Conclusions: We describe the successful adoption of simple safety measures introduced into routine practice. These comprised videolaryngoscopy, ramped positioning and low flow nasal oxygen. Their introduction was supported by the implementation of an intubation checklist and multidisciplinary team training.
    MeSH term(s) Humans ; Female ; Pregnancy ; Laryngoscopy/adverse effects ; Laryngoscopy/methods ; Quality Improvement ; Intubation, Intratracheal/methods ; Airway Management/adverse effects ; Airway Management/methods ; Laryngoscopes ; Oxygen
    Chemical Substances Oxygen (S88TT14065)
    Language English
    Publishing date 2023-08-23
    Publishing country England
    Document type Journal Article
    ZDB-ID 605770-6
    ISSN 1365-2346 ; 0265-0215
    ISSN (online) 1365-2346
    ISSN 0265-0215
    DOI 10.1097/EJA.0000000000001897
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    In stock of ZB MED Cologne/Königswinter

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  10. Article ; Online: The Airway Lead: opportunities to improve institutional and personal preparedness for airway management.

    McNarry, Alistair F / M Cook, Tim / Baker, Paul A / O'Sullivan, Ellen P

    British journal of anaesthesia

    2020  Volume 125, Issue 1, Page(s) e22–e24

    MeSH term(s) Airway Management/methods ; Anesthesiology/methods ; Anesthesiology/organization & administration ; Clinical Competence ; Humans ; Leadership
    Keywords covid19
    Language English
    Publishing date 2020-04-27
    Publishing country England
    Document type Editorial
    ZDB-ID 80074-0
    ISSN 1471-6771 ; 0007-0912
    ISSN (online) 1471-6771
    ISSN 0007-0912
    DOI 10.1016/j.bja.2020.04.053
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