| Confirmation of the ability to ventilate by facemask before administration of neuromuscular blocker: a non-instrumental piece of information? | |
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MedLine Citation:
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PMID: 20042476 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Our aim was to determine whether anaesthetists routinely confirm their ability to ventilate a patient's lungs by a facemask before the administration of a neuromuscular blocker and the rationale for this practice. METHODS: An online survey of trainee and non-trainee anaesthetists working in hospitals forming part of the Central London School of Anaesthesia collected 136 complete data sets over a 3 month period. RESULTS: Seventy-eight of 136 (57%) routinely checked they could ventilate by the facemask ('checkers'). The reasons given for this varied, though the most common was the ability to 'enable escape wake-up'. The practice was most commonly adopted by anaesthetists with less experience. In a hypothetical 'cannot ventilate' scenario, the use of succinylcholine was advocated by the majority of respondents, both 'checkers' and 'non-checkers'. CONCLUSIONS: Despite the lack of firm evidence to support the practice of confirming the ability to ventilate the lungs before administering a neuromuscular blocking drug (NMB), we found strongly held views that supported the practice and equally strongly held views that opposed it. However, in a hypothetical emergency situation where ventilation by the facemask after induction of anaesthesia was impossible, the majority of respondents (including 'checkers') would administer a neuromuscular blocker. This apparent paradox can be explained by well-recognized psychological mechanisms. We suggest that in checking the ability to ventilate by the facemask, some anaesthetists are seeking information that may be relevant but not instrumental in deciding when to administer an NMB. |
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Authors:
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R H Broomhead; R J Marks; P Ayton |
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Publication Detail:
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Type: Journal Article Date: 2009-12-30 |
Journal Detail:
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Title: British journal of anaesthesia Volume: 104 ISSN: 1471-6771 ISO Abbreviation: Br J Anaesth Publication Date: 2010 Mar |
Date Detail:
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Created Date: 2010-02-12 Completed Date: 2010-03-18 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0372541 Medline TA: Br J Anaesth Country: England |
Other Details:
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Languages: eng Pagination: 313-7 Citation Subset: IM |
Affiliation:
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Department of Anaesthesia, Royal Free Hospital London, Hampstead, UK. bobbroomhead@gmail.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Anesthesiology
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education Clinical Competence Education, Medical, Graduate / methods Female Health Care Surveys Humans London Male Masks* Medical Staff, Hospital / standards Neuromuscular Blockade / methods, standards* Neuromuscular Blocking Agents / administration & dosage Professional Practice / statistics & numerical data Respiration, Artificial / methods, standards* |
| Chemical | |
Reg. No./Substance:
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0/Neuromuscular Blocking Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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