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Oct 6 • 5 tweets • 3 min read
The law and airway management, looking at what we do through a different lens now with Maryanne Balkin. The tort of negligence has 4 elements:
1. duty of care
2. breach of standard of care
3. causation
4. injury or harm

#DAS2022
Expert witnesses are paramount in establishing the standards of care in cases where there is an issue with diagnosis or treatment #DAS2022
Recent medicolegal claim data from the NHS in England - …-publications.onlinelibrary.wiley.com/doi/abs/10.111…
Legal obligations:
doctors - knowledge and experience with new developments and practice guidelines, intentional and appropriate airway planning and documentation

institutions - resources, equipment and education tailored to casemix #DAS2022
Evolution of UK law for consent - 2015 Montgomery vs Lanarkshire, consent is a multistage and dynamic process. An absolute must read bit of case law supremecourt.uk/cases/docs/uks…

themdu.com/guidance-and-a…

gmc-uk.org/ethical-guidan…

#DAS2022

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More from @dastrainees

Difficult Airway Society (DAS) Trainees Profile picture
Oct 6
Peri-extubation complications - where are we? @MatteoParotto #DAS2022
For every study on extubation there are almost 10 on intubation, we don't appear to pay as much attention for extubation....#DAS2022
NAP 4 showed that extubation is where a significant amount of airway complications occur #DAS2022
Read 7 tweets
Difficult Airway Society (DAS) Trainees Profile picture
Oct 6
Why do we used cuffed tracheal tubes in children? Starting the international session this afternoon, the links @dasairway has with other airway societies is wonderful
The subglottic area is the narrowest part in children, the resistance whilst advancing the ETT is due to stenosis in the subglottic region #DAS2022
Microcuff paediatric ETT have really changed practice, moving from uncuffed tubes to cuffed tubes in paediatric patients #DAS2022
Read 5 tweets
Difficult Airway Society (DAS) Trainees Profile picture
Oct 6
Preventing unrecognised oesophageal intubation from @doctimcook. The recent guideline is an absolute must read …-publications.onlinelibrary.wiley.com/doi/full/10.11…
For me the saddest part of @doctimcook's anatomy of an unrecognised oesophageal intubation

"family plead for it not to happen to others"

#DAS2022
Sharon Grierson, Peter Saint, Glenda Logsdail...

Families left without their loved ones. Families pleading not for this to happen to any other families

#DAS2022
Read 10 tweets
Difficult Airway Society (DAS) Trainees Profile picture
Oct 6
The wonderful @Fionafionakel updating on human factors guidelines that are coming from DAS soon.....#DAS2022
Human factors are not just non-technical skills, design of safe systems is the most important aspect in #DAS2022
Humans are fallible, healthcare is relying on high levels of human performance but this is not a fail safe mechanism and performance is liable to fall off in high pressure situations #DAS2022
Read 14 tweets
Difficult Airway Society (DAS) Trainees Profile picture
Oct 6
Mass casualty events @karimbrohi - recent special issue of the @BJAJournals is a must read bjanaesthesia.org/issue/S0007-09…

Anaesthetists are right in the middle of this when they occur....has your department thought about this and what are your plans? #DAS2022
Phases of mass casualty events
Chaos - the unknown and the surge
Reception - patients arrive
Consolidation
Definitive Care
Rehabilitation - for patients, staff and the department #DAS2022
Tension occurs between casualty flow, providing optimal trauma care and constrained resources #DAS2022

To manage this tension:
Effective and multiple time-point triage by experts
Damage control response to protect resources and maintain institutional capability
Leadership
Read 6 tweets
Difficult Airway Society (DAS) Trainees Profile picture
Oct 6
Pre-hospital urban trauma in London - Dr Claire McCahill. Majority penetrating trauma and relating to knife crime, road traffic collisions, fall from height - also trains and underground incidents #DAS2022
Safety concerns with knife crime - wearing a stab vest to intubate sounds awful #DAS2022
Data from London Airway Ambulance 99.3% initial success rate for intubation. Standardised techniques, standardised drugs, use of a bougie for every intubation and a check and challenge checklist #DAS2022
Read 6 tweets

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