Patient safety improvement initiatives

Securing an airway device is a critical component of patient safety, particularly in situations where airway management is essential to life support, such as during surgery, emergency care or critical illness. The airway device, typically an endotracheal tube (ETT) or laryngeal mask airway (LMA) ensures that a patient's airway remains open for adequate oxygenation and ventilation. A wide range of airway devices and techniques have been created to enhance the safety of airway management. However, as Gaszyński et al point out, airway management remains a challenge.¹

Ensuring proper securing of the device is paramount as any displacement or dislodgement can lead to life-threatening complications like hypoxia, aspiration or airway obstruction. Additionally, off-label materials commonly used to secure the airway, such as tape and ties, can cause facial damage ranging from minor redness to severe tissue damage. Tape especially is an infection risk, but perhaps more pertinently; any off-label methods are not fit for purpose. Although they are imbedded in healthcare culture and have been used the world over for generations, tape and ties were never designed to perform airway securement.

In October 2023, Pentland Medical and Dawn Stott Associates formed a working relationship to raise awareness of the hazards and patient safety risks associated with securing a patient airway device in the theatre and critical care environments. Following an inaugural round table discussion meeting it was agreed that a 'cross sector' Short Life Working Group (SLWG) would be formed to facilitate a consultation on the way an airway device is currently secured when a patient is undergoing a surgical intervention. The group's goals were acknowledged as identifying systemic barriers to the standardisation of airway management and to develop guidance to support a more robust and consistent way of securing the airway device.