Emergency airway management in resource limited setting

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Abstract

Background

Emergency airway management in resource-limited settings presents multifaceted challenges due to shortages in essential medical resources, healthcare professionals, and infrastructure.

Methods

We conducted a literature search using keywords “Emergency Airway Management” “Low Resource” “Africa” “Asia” from databases such as Pubmed, and Google Scholar, from where we extracted relevant literature for our study.

Findings

These limitations resulted in delayed interventions, suboptimal care, and higher complication rates during intubation procedures. However, innovative solutions have emerged to address these challenges, including cost-effective airway management devices and training programs tailored for non-medical personnel. Capacity building and local empowerment are critical components of improving emergency airway management in these settings. Additionally, advocating for policy support and investment in healthcare infrastructure is essential to ensure access to essential equipment and adequate staffing. Collaboration and knowledge-sharing networks among healthcare professionals and organisations are pivotal in disseminating best practices and advancing healthcare delivery in resource-limited regions.

Conclusion

Future efforts should focus on tailored training programs, rigorous research, innovative device development, telemedicine solutions, sustainable capacity building, and advocacy to enhance emergency airway management in resource-limited settings.

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Most cited references 23

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Identifying Key Challenges Facing Healthcare Systems In Africa And Potential Solutions

Obinna O Oleribe, Jenny Momoh, Benjamin SC Uzochukwu … (2019)

Introduction Healthcare systems in Africa suffer from neglect and underfunding, leading to severe challenges across the six World Health Organization (WHO) pillars of healthcare delivery. We conducted this study to identify the principal challenges in the health sector in Africa and their solutions for evidence-based decisions, policy development and program prioritization. Methods The study was conducted as part of a recent African Epidemiological Association Meeting in Maputo, Mozambique with participants drawn from 11 African countries, Cuba, Portugal and the United Kingdom. Participants were divided into 10 groups, consisting of 7 to 10 persons each. Brainstorming approaches were used in a structured, modified nominal group process exercise to identify key challenges and strategies to mitigate healthcare service challenges in Africa. Identified challenges and solutions were prioritised by ranking 1–5, with 1 most important and 5 being least important. Results The first three challenges identified were inadequate human resources (34.29%), inadequate budgetary allocation to health (30%) and poor leadership and management (8.45%). The leading solutions suggested included training and capacity building for health workers (29.69%), increase budgetary allocation to health (20.31%) and advocacy for political support and commitment (12.31%). Conclusion The underdeveloped healthcare systems in Africa need radical solutions with innovative thought to break the current impasse in service delivery. For example, public-private initiatives should be sought, where multinational companies extracting resources from Africa might be encouraged to plough some of the profits back into healthcare for the communities providing the workforce for their commercial activities. Most problems and their solutions lie within human resources, budget allocation and management. These should be accorded the highest priority for better health outcomes.

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The WFSA Global Anesthesia Workforce Survey

Peter Kempthorne, Wayne Morriss, Jannicke Mellin-Olsen … (2017)

Safe anesthesia and surgical care are not available when needed for 5 billion of the world's 7 billion people. There are major deficiencies in the specialist surgical workforce in many parts of the world, and specific data on the anesthesia workforce are lacking.

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The difficult airway with recommendations for management – Part 1 – Difficult tracheal intubation encountered in an unconscious/induced patient

J Adam Law, Natasha Broemling, Richard Cooper … (2013)

Background Previously active in the mid-1990s, the Canadian Airway Focus Group (CAFG) studied the unanticipated difficult airway and made recommendations on management in a 1998 publication. The CAFG has since reconvened to examine more recent scientific literature on airway management. The Focus Group’s mandate for this article was to arrive at updated practice recommendations for management of the unconscious/induced patient in whom difficult or failed tracheal intubation is encountered. Methods Nineteen clinicians with backgrounds in anesthesia, emergency medicine, and intensive care joined this iteration of the CAFG. Each member was assigned topics and conducted reviews of Medline, EMBASE, and Cochrane databases. Results were presented and discussed during multiple teleconferences and two face-to-face meetings. When appropriate, evidence- or consensus-based recommendations were made together with assigned levels of evidence modelled after previously published criteria. Conclusions The clinician must be aware of the potential for harm to the patient that can occur with multiple attempts at tracheal intubation. This likelihood can be minimized by moving early from an unsuccessful primary intubation technique to an alternative “Plan B” technique if oxygenation by face mask or ventilation using a supraglottic device is non-problematic. Irrespective of the technique(s) used, failure to achieve successful tracheal intubation in a maximum of three attempts defines failed tracheal intubation and signals the need to engage an exit strategy. Failure to oxygenate by face mask or supraglottic device ventilation occurring in conjunction with failed tracheal intubation defines a failed oxygenation, “cannot intubate, cannot oxygenate” situation. Cricothyrotomy must then be undertaken without delay, although if not already tried, an expedited and concurrent attempt can be made to place a supraglottic device.

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Author and article information

Contributors

Mohammed Alsabri Hussein Alsabri: alsabri5000@gmail.com

Journal

Journal ID (nlm-ta): Int J Emerg Med

Journal ID (iso-abbrev): Int J Emerg Med

Title: International Journal of Emergency Medicine

Publisher: Springer Berlin Heidelberg (Berlin/Heidelberg )

ISSN (Print): 1865-1372

ISSN (Electronic): 1865-1380

Publication date (Electronic): 14 March 2024

Publication date PMC-release: 14 March 2024

Publication date Collection: 2024

Volume: 17

Electronic Location Identifier: 41

Affiliations

[1 ]Department of Medicine and Surgery, University of Ilorin, ( https://ror.org/032kdwk38) Ilorin, Nigeria

[2 ]Department of Medicine and Surgery, Ladoke Akintola University of Technology, ( https://ror.org/043hyzt56) Ogbomoso, Nigeria

[3 ]Althawara Moderen General Hospital, Sanaa, Yemen

Article

Publisher ID: 607

DOI: 10.1186/s12245-024-00607-3

PMC ID: 10938719

PubMed ID: 38486140

SO-VID: d2dfa0e6-40f6-4f00-810b-3533e5f14c14

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 10 October 2023

Date accepted : 22 February 2024

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ScienceOpen disciplines: Emergency medicine & Trauma

Keywords: emergency airway management,resource-limited settings

Data availability:

ScienceOpen disciplines: Emergency medicine & Trauma

Keywords: emergency airway management, resource-limited settings

Emergency airway management in resource limited setting

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Abstract

Background

Methods

Findings

Conclusion

Related collections

Preventive and Emergency Medicine Insights

Most cited references 23

Identifying Key Challenges Facing Healthcare Systems In Africa And Potential Solutions

The WFSA Global Anesthesia Workforce Survey

The difficult airway with recommendations for management – Part 1 – Difficult tracheal intubation encountered in an unconscious/induced patient

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