Prophylactic cannula cricothyroidotomy and percutaneous oxygen insufflation with the Rapid-O2®: A simple and effective tool for enhancing safety in difficult airway management.

Prophylactic cannula cricothyroidotomy is a recognised technique for actual or potential difficult airway management, where it confers a number of technical and non-technical benefits. Oxygenation with this technique is traditionally achieved by way of pressure-regulated, high flow jet ventilation and requires specialised equipment and considerable expertise for safe use, neither of which are always readily available. As an alternative, we describe the management of two patients with progressive upper airway obstruction in whom prophylactic cannula cricothyroidotomy and oxygen insufflation were performed using equipment which we consider is safer, widely available and already familiar to most anaesthetists throughout Australia.

A proposed system for standardization of colour-coding stages of escalating criticality in clinical incidents.

Purpose Of Review: This article proposes a standardized framework for colour-coding states of criticality in clinical situations and their respective escalated responses.

Recent Findings: The first level is a green zone representing a 'safe' space (to proceed), where any hazards are controlled, latent or undetectable. The second is an amber zone, where hazards are known to be present, but one can proceed with caution and increased vigilance, and where defences are used to prevent escalation to a crisis.

e-Learning in regional anesthesia.

Purpose Of Review: To explore the role and impact of e-learning technologies on regional anesthesia.

Recent Findings: 21st century technologies, such as 'smart' medical appliances, personal computers, sophisticated apps, the ubiquitous Internet, and online 'e-learning' curricula, are having a powerful impact on anesthesia training: when we learn, what we learn, and how we learn. But is 'new' necessarily 'better'? The answer will result from the application of developments in IT technology through the current vision of architects of future anesthesia training programs.

The Bowtie diagram: a simple tool for analysis and planning in anesthesia.

Purpose Of Review: The purpose is to show the advantages of a Bowtie diagram as a versatile tool for displaying and understanding the evolvement and management of critical incidents.

Recent Findings: The Bowtie diagram has been used recently in anesthesia to depict critical incidents having been used in high-risk industries for several decades. This diagram displays the progression from latent factors to potential harm in five steps.

Safety Analysis of 13 Suspicious Deaths in Intensive Care: Ergonomics and Forensic Approach Compared.

Objectives: Thirteen suspicious deaths occurred in an intensive care unit of Tuscany, Italy, in 2015. All patients developed sudden unexplained coagulopathy leading to severe bleeding. None of them had been prescribed heparin, but supertherapeutic concentrations of heparin were found.