Individual sessions

Overview

Introduction

Aims and content

Format

 Duration
Welcome, introductions by participants, sponsors, aims of the workshop, overview of the program and housekeeping. PowerPoint/discussion/introductions by participants 15 min

Session 1: Why is CICO a problem?

Aims and content

Format

 Duration
  1. Persuade audience that this is a problem worthy of addressing in a holistic way, i.e., techniques, human factors and systems
  2. Ask the group to consider criteria for declaring CICO – introduce transition algorithm
  3. Introduce concepts and algorithms to be used in course: '3 stages' (Supraglottic Rescue – Transition decision – Infraglottic Rescue) and '3 components of each' (Vortex and infraglottic rescue)
 PowerPoint, discussion, Elaine Bromiley video (first 7 minutes), lessons from NAP4 20 min

Session 2: Supraglottic airway rescue and transition to CICO

Aims and content

Format

 Duration
  1. Presents Vortex model for supraglottic rescue and stresses importance of attempting all components before transitioning to infraglottic rescue
  2. Explores clinical criteria for transitioning to infraglottic rescue using case examples
 PowerPoint talk  and discussion 25 min

Session 3: Supraglottic rescue workstations

Aims and content

Format

 Duration
Practice content of previous talk Concurrent practical workstations (all equivalent) 30 min
Group A - Group B - Group C    

Session 4: Managing a CICO situation - Infraglottic rescue

Aims and content

Format

 Duration
Explain three parts of Andrew Heard’s CICO algorithm (aligned with workshop stations 1-3) of Session 5 PowerPoint talk, video demonstration, demonstrate CICO kit 20 min

Session 5: Infraglottic rescue workstations

Aims and content

Format

 Duration

Practical workstations 
Workstation 2 can be run as doctors’ version (practice techniques) and nurses version (practice set-up)

 Concurrent rotating workstations rounds 1-3 120 min
1: Cannula cricothyroidotomy/Jet oxygenation 2: MelkerTM conversion 3: Scalpel-bougie/Scalpel-Finger-Cannula techniques
3: Scalpel-bougie/Scalpel-Finger-Cannula techniques 1: Cannula cricothyroidotomy/Jet oxygenation 2: MelkerTM conversion
2: MelkerTM conversion 3: Scalpel-bougie/Scalpel-Finger-Cannula techniques 1: Cannula cricothyroidotomy/Jet oxygenation
4: Practice scenario 4: Practice scenario 4: Practice scenario

All groups practice the same exercise which is an integrated rehearsal of the '3 Stages'.

  

Session 6: Managing transition - 7 failure factors and strategies

Aims and content

Format

 Duration

Seven failure (human) factors and strategies including communication, assertiveness, team-work

  1. How clinicians underperform in crises - includes analysis and recommendations from Elaine Bromiley case and others
  2. Introduce 7 failure factors model
  3. Refer also to Riley/Greenland/RHCE working party ANZCA Bulletin articles
  4. Practice assertiveness phrases
Discussion 30 min

Session 7: Integrated practice scenarios

Aims and content

Format

 Duration

Integrates all lessons (technical and human factors) and recommendations including:

  • Practice guidelines/algorithms
  • Equipment  including 'CICO Kit'
  • Coordinated team approach:  team roles, record keepers and time prompts, good communication with appropriate assertiveness
 Concurrent mini team-based simulation scenarios x 4. Scenarios contain human factors challenges 90 min
Group A, B and C: Scenario 1 - 4  

Session 8: Being prepared for CICO - Equipment and systems

Aims and content

Format

 Duration
  • Assess an institution’s preparedness for this crisis. Presents checklist that could be used as a quality assurance/risk management tool
  • Encourage systems change including: routine training/rehearsal including how departments can deliver training, adoption of uniform equipment and algorithms

Talk and discussion resource: Preparedness checklist
Based on article in ANZCA Bulletin by RHCE Working party

 15 min

The Structure and format page provides an example of a timetable if all 8 sessions are to be run in one day.

Course description icon Course description

Preparation icon Preparation

Sessions icon Individual sessions

Video icon Videos, algorithms
and fact sheets