I have uploaded a new colour coded CICO flowchart and equipment pack PDF, reflecting the move from the Enk to Rapid-O2 device. You can download a copy from the CICO page.
Category Archives: CICO
Gold Coast CICO course information
New CICO packs
With the CICO “pink” packs (cannula crico/tracheotomy) nearing expiry at many hospitals, I have decided to update them with new equipment. The Enk kits will be replaced by the “Rapid O2” device and 14ga insyte cannulas. This brings us in line with Andy Heard’s recommended equipment for use with his algorithm.
Further information may be found here;
http://www.diathermy.net/downloads/flyers/rapid_02_flyer.pdf
In short, they are easier to use than the Enk, cheaper, and give better feedback if there is obstruction. Roll out of this device will occur across facilities as packs expire.
The Rapid O2 rep will be at GCPH from 10:00 to 14:00 on Thursday 20th July to conduct education with the device.
Please contact me if you have any concerns, or would like further information.
Kind regards,
Ian Cameron.
ANZCA Safety Updates
Implementation of non-luer, non-interconnectable neuraxial connectors
The International Organization for Standardization (ISO) standard for device connectors used for neural applications has been published. The devices on which these connectors will be used are neuraxial, including spinal and epidural access, cerebral intraventricular drainage and access devices, peripheral nerve anaesthesia devices and associated equipment required such as syringes, infusion connectors (patient end) etc. See ISO 80369-6 Small bore connectors for liquids and gases in healthcare applications – Part 6: Connectors for neuraxial applications.
ANZCA’s position on CICO
ANZCA has clarified its position on can’t intubate, can’t oxygenate (CICO) front of neck access in response to the release of the Royal College of Anaesthetists’ (RCoA) statement “Anaesthetists and surgeons reach agreement on front of neck emergency techniques in life-threatening ‘CICO’ situations”, associated with a BJA editorial “Surgical intervention during a can’t intubate can’t oxygenate (CICO) event: emergency front of neck airway (FONA)?”. The College does not “mandate” one approach to FONA over the other for a number of reasons. For more information, please see here.
New airway assessment resource
A new resource, Airway Assessment, has been produced for use by ANZCA Fellows and trainees to improve understanding and to guide management of airway assessment and difficult airways. It is the first of a series of airway resources and complements the Transition to CICO resource document (and ANZCA professional document PS61).
Practice points: postoperative monitoring
Understanding the time periods of highest risk and individual patient risk factors for respiratory depression may assist in efficient resource allocation in postoperative patients. Drug-induced respiratory depression is associated with significant morbidity and mortality in the postoperative period and medical devices such as telemetry systems are a valuable resource often used for monitoring patients after surgery. Read the full article on the TGA website.
Emergency Scenarios – Gold Coast Private Hospital
Update
Attendance list now available for download.
Please log in to download attendance list
Jo Bruton is organising a week of team training emergency scenarios at the new Gold Coast Private Hospital (GCPH, the “new” Allamanda). The purpose of these activities is to test the emergency systems that will be in place at the new facility. You will be relying on these systems for real emergencies once the GCPH opens, so it is in your own best interests to participate!
Provisional Details
- Dates: Monday 29/2 – Thursday 3/3/2016
- Times: 1800 – 2100
- Venue: Gold Coast Private Hospital
- Activities:
- Cardiac arrest and advanced life support
- Can’t intubate, can’t oxygenate
- Massive haemorrhage
- Anaphylaxis
Attendance will attract 2 credits per hour for ANZCA CPD under “Practice Evaluation – Team training scenario within own work environment, with usual work team.” (Please note that these do not fill the requirements for compulsory emergency response activities.)
Please let Jo know ASAP if you plan to attend, and if you are interested in helping run some of the activities. We need to know numbers to help plan the evenings.
Airway Articles
Hugh Stephens has graciously supplied the following articles on airway management;
- Airway risk assessment – a review of current evidence to aid clinical decision-making Download
- Airway management roundtable – six international airway experts offer their opinions on various airway matters Download
- Submental tracheal intubation for a patient with multiple facial fractures – let me know if you plan to do one of these and I’ll come and watch Download
If you come across any interesting articles that you think are worth sharing, please contact me and I’ll post details on GCAPE.
Annual Airway Workshop – Friday 12th June 2015
(Posted on behalf of Peter McLaren)
Annual Airway Workshop 2015
- Friday 12th June in the Allamanda lecture room
- 5 – 6.00pm – Technicians and nursing staff
- 6 – 7.00pm – Medical staff
Hi,
Just a short notice on this year’s difficult airway workshop to be held at Allamanda Hospital on Friday, 12th June.
Syd has still to confirm all the participants but Storz will be there with the CMAC, Cook will be there with Ian Cameron demonstrating percutaneous cricothyroidotomy and we hope Ambu will be there to demonstrate the King Vision system recently acquired by Pacific Private. It’s a great chance for some hands-on experience with gear you may not use often. It may also help with deciding future equipment purchases, especially in areas such as ED and ICU where dedicated difficult airway equipment may not have the penetration of that in OR.
The format of other years will continue with more of a nursing staff orientation from 5 to 6pm and a more medical take on things from 6 to 7pm. Food and drink will be provided. It will be held in the education room, near the admin offices with access via the staff cafeteria.
A further notice will be sent closer to the date.
For some of you who have been incorrectly emailed. I am using an old contact list and any who no longer wish to receive these emails, please reply ‘unsubscribe’. For those of you who have enjoyed these workshops in the past, please forward this email on to other staff perhaps at other hospitals or in other units who may be interested. Continuing education certificates will be given to all participants. Please RSVP or contact Syd for catering purposes.
Cheers,
Peter McLaren
CICO Workshop 26/7/14 report
Thank you to our four instructors, Ioana, David, Peter, and Rod who all did a wonderful job. Also, many thanks to our practice manager Victoria who over-ruled my “no frills” directive and provided coffee and pastries for the morning.
CICO Workshop 26/7/2014
Registration is now open for the inaugural Gold Coast CICO Workshop.
9.00 am Saturday 26th July 2014, Southport.
Please head over to the CICO page to register online.
Obligatory ANZCA statement:
Participants in the ANZCA CPD Program may claim this CICO course as an emergency response activity in their CPD portfolio.
Please note that this activity has been recognised as suitable to be claimed in the emergency responses category of the ANZCA CPD program. The course content has not been assessed and this recognition does not represent endorsement by ANZCA.
Please note the following important points
- It’s free!
- It’s low stress!
- It’s on Saturday 26th July, at 9am.
- It’s being held in the SAS rooms, Suite 12, 82-86 Minnie St Southport. Everyone is welcome.
- The course will be based on the CICO algorithm and packs that have recently been introduced into Allamanda and Pindara.
- Due to College requirements numbers are strictly limited, so it’s first in, first served. If you miss out we’ll put you on a reserve list, but don’t worry, the course will be repeated until everyone who wants to do it gets the chance.
- If you have already done your CPD Emergency Response Activities, please let those who haven’t have first dibs.
Frequently Asked Questions
- Is this a high fidelity wet lab workshop?
- No, this workshop is decidedly Lo-Fi, with airway models made out of old tubes and sticky tape.
- Then why on earth should I bother?
- It’s free!
- It’s CPD!
- It’s good for you! You’ll get to learn the CICO algorithm and practice with the CICO kits that are being introduced into the hospitals.
- Will you be serving champagne and caviar?
- No, we will not be providing any refreshments, although there will be plenty of water in the tap.
- Will you be providing printed handouts, USB sticks, or CD’s?
- No, you will be emailed documents prior to the workshop which you can print out. Can you sense a bit of a theme here?
- No, you will be emailed documents prior to the workshop which you can print out. Can you sense a bit of a theme here?
- What’s in it for you, and why are you doing this?
- Your CICO instructors are not receiving any payments, inducements, or freebies, just a warm fuzzy feeling from helping the local community tackle the new CPD. Cook Medical has helped out by supplying some of the equipment.
- Your CICO instructors are not receiving any payments, inducements, or freebies, just a warm fuzzy feeling from helping the local community tackle the new CPD. Cook Medical has helped out by supplying some of the equipment.
- I’m a CICO expert!
- Well, that’s not a question, but thanks for letting us know. Please volunteer as an instructor for future workshops.