Assessor Resource

HLTANA003
Assist with airway management

Assessment tool

Version 1.0
Issue Date: March 2024


This unit describes the skills and knowledge required provide assistance to the anaesthetist in airway management during anaesthesia and resuscitation, including difficult and emergency airways.

The unit applies to anaesthetic technicians working under the direction of, and in consultation with, an anaesthetist, in any hospital or day surgery setting.

The skills in this unit must be applied in accordance with Commonwealth and State/Territory legislation, Australian/New Zealand standards and industry codes of practice.

You may want to include more information here about the target group and the purpose of the assessments (eg formative, summative, recognition)



Evidence Required

List the assessment methods to be used and the context and resources required for assessment. Copy and paste the relevant sections from the evidence guide below and then re-write these in plain English.

ELEMENT

PERFORMANCE CRITERIA

Elements define the essential outcomes

Performance criteria describe the performance needed to demonstrate achievement of the element

1. Select, check and prepare airway management equipment in accordance with manufacturer’s guidelines

1.1 Review information about client and type of surgical procedure and anticipate type and calculate size of airway management equipment

1.2 Identify and respond to situations where anaesthetist needs to confirm selection

1.3 Conduct pre-use safety check of selected equipment

1.4 Diagnose airway management equipment faults and rectify within scope of role

1.5 Prepare and position equipment for use following safe manual handling techniques

2. Perform bag and mask ventilation

2.1 Position patient for bag/mask ventilation

2.2 Confirm adequate ventilation and rectify any issues preventing adequate ventilation

2.3 Insert oropharyngeal and/or nasopharyngeal airway if indicated

2.4 In consultation with the anaesthetist determine when to cease bag/mask ventilation

3. Assist with insertion of supraglottic airway devices (SAD)

3.1 Select, conduct pre-use check and prepare (SAD)

3.2 Anticipate needs of the anaesthetist

3.3 Assist with positioning of client

3.4 Provide assistance during insertion

3.5 Inflate cuff of SAD in accordance with manufacturer’s guidelines, clinical indications and anaesthetist’s directions

3.6 Secure airway into position when directed

4. Assist with insertion of endotracheal, orally or nasally and/or endobronchial tubes

4.1 Select, conduct pre-use check and prepare endotracheal or endobronchial tube and other intubation equipment

4.2 Assist with positioning of client for intubation

4.3 Anticipate needs of the anaesthetist

4.4 Provide assistance with insertion including use of stylet, bougie and/or cricoid manipulation

4.5 If applicable, inflate cuff according to industry standard.

4.6 When indicated, assist with insertion of throat pack including appropriate documentation of insertion/removal

4.7 If directed, use a stethoscope to identify breathing sounds

4.8 Secure airway into position when directed

5. Assist with rapid sequence induction

5.1 Determine rationale for rapid sequence induction

5.2 Select, conduct pre-use check and prepare equipment for rapid sequence induction

5.3 Inform client of procedures to be completed by the anaesthetic technician

5.4 Apply cricoid pressure , monitor patient for vomiting and remove pressure when instructed by the anaesthetist

5.5 Assist with insertion of endotracheal tube

5.6 Secure airway into position if directed.

6. Assist with predicted difficult airway/intubation

6.1 Discuss and confirm equipment preparation, intubation plan and contingencies with anaesthetist

6.2 Select, undertake pre-use safety checks and prepare required equipment

6.3 Inform client of tasks to be undertaken by anaesthetic technician.

6.4 Anticipate anaesthetist needs in patient preparation and assist throughout intubation

6.5 When appropriate, return clean equipment to storage location and send used equipment for processing.

6.6 Debrief with anaesthetic team on outcome of intubation.

7. Assist with connection/ disconnection of client to/from ventilation equipment

7.1 Select and prepare ventilation equipment and materials

7.2 Set ventilation modes and parameters and ensure warning devices are switched on, tested and are registering that the equipment is safe prior to use with client

7.3 Observe equipment whilst in use and take action immediately if fault develops to avoid danger to equipment, clients and staff

7.4 Follow established procedures to rectify faulty equipment

7.5 Check client’s physiological parameters when required or as directed by anaesthetist

7.6 Identify, validate and report deviations from acceptable limits of physiological parameters to the medical practitioner

7.7 Report signs of client discomfort, distress or adverse reaction to the anaesthetist

8. Assist in management of client’s airway during emergence phase

8.1 Assist anaesthetist with client positioning to facilitate management of client’s airway

8.2 Assist anaesthetist to optimise oxygenation of client

8.3 Assist with oral/nasal/endotracheal/SAD suctioning.

8.4 Assist anaesthetist as required during SAD removal or extubation and be prepared for possible reintubation

8.5 Provide reassurance to the client and take action to limit injury

8.6 Observe client’s condition throughout the procedure and take action when required or at the direction of the anaesthetist

The candidate must show evidence of the ability to complete tasks outlined in elements and performance criteria of this unit, manage tasks and manage contingencies in the context of the job role. There must be evidence that the candidate has:

followed established airway management processes and techniques including performing or assisting with at least 10 of each of the following:

pre-oxygenation

bag or mask ventiliation

Supraglottic Airway Device (SAD) insertion

oral insertion of endotracheal tubes

airway management during emergence

followed established airway management processes and techniques including performing or assisting with at least 3 of each of the following:

endobronchial tube insertion

nasal insertion of endotracheal tubes

laser tubes

rapid sequence induction

predicted difficult airway

attaching clients to ventilators

tracheostomy tube

performed or assisted with airway management on different client types of varied ages, both conscious and unconscious

responded and adapted to airway management problems:

routine

unpredictable

The candidate must be able to demonstrate essential knowledge required to effectively complete tasks outlined in elements and performance criteria of this unit, manage tasks and manage contingencies in the context of the work role. This includes knowledge of:

legal and ethical considerations (national, state/territory) for airway management, and how these are applied in organisations:

codes of practice

duty of care

infection prevention and control

informed consent

mandatory reporting

privacy, confidentiality and disclosure

records management

rights and responsibilities of workers, employers and clients

work role boundaries – responsibilities and limitations

work health and safety (WHS)

considerations for airway management in different types of surgery, including:

general/regional/local anaesthetic and sedation

remote site - radiology, electroconvulsive therapy (ECT) & endoscopy

general/gastro-intestinal surgery

ear, nose and throat surgery

gynaecological surgery

obstetric surgery

orthopaedic surgery

vascular surgery

urological surgery

oral/dental/maxillofacial surgery

cardiothoracic surgery

neurosurgery

plastic surgery

trauma/emergency surgery

ophthalmic surgery

paediatric

airway equipment, including function and operating guidelines, use, indications and limitations, and criteria for withdrawal for:

laryngoscopes blades

fibreoptic bronchoscopes

videoscopes

cricothyrotomy kits

oral and nasal airways

oral endotracheal tubes

laser tubes

nasal endotracheal tubes

tracheostomy tubes

endobronchial tubes

supraglottic airway devices

jet insufflations

intubation adjuncts – bougie, stylet, Magill’s forceps

types of suction equipment, its indication for use and hazards associated with usage

airway management procedures, common issues and scope of technician role in:

bag or mask ventilation

Supraglottic airway device insertion

insertion of endotracheal tube, orally or nasally and endobronchial tubes

rapid sequence induction

predicted difficult airway

airway management during emergence

emergency airway algorithms

gas induction

client considerations for airway management:

relationship between client positioning techniques and optimal airway management

pre-medications and their effects on respiration

causes, signs and symptoms of loss of airway

remedial actions to address loss of airway

type of surgery, including shared airway

anatomy, physiology and pathophysiology factors that impact airway management for different client groups

medical terminology specific to airway management

roles and responsibilities of those participating in the anaesthetic procedure

Australian and New Zealand College of Anaesthetists (ANZCA) Policy guidelines andDifficult airway society guidelines

The following aspects of the performance evidence must have been demonstrated in the workplace with the addition of simulations and scenarios where the full range of contexts and situations have not been provided in the workplace:

followed established airway management processes and techniques including performing or assisting with at least 10 of each of the following:

pre-oxygenation

bag or mask ventilation

SAD insertion

oral insertion of endotracheal tubes

airway management during emergence

The following aspects of the performance evidence must have been demonstrated in the workplace or in a simulated environment that reflects workplace conditions:

followed established airway management processes and techniques including performing or assisting with at least 3 of each of the following:

laser tubes

rapid sequence induction

predicted difficult airway

attaching clients to ventilators

nasal insertion of endotracheal tubes

endobronchial tube insertion

gas induction

tracheostomy tube

failed airway scenarios

The following conditions must be met for this unit:

use of suitable facilities, equipment and resources, including:

airway management equipment:

nasal and oral endotracheal tubes

tracheostomy tubes

laryngoscopes, including video, conventional, McCoy and fibreoptic

video or fibreoptic bronchoscopes

endobronchial tubes/endobronchial blockers

other difficult intubation equipment

emergency airway equipment

intubation aids (e.g. stylet, bougie, exchange catheter)

oropharyngeal/nasopharyngeal airways

Supraglottic airways

anaesthetic circuits

self inflating bag resuscitator

face masks

connectors

filters

Magill’s forceps

general medical equipment:

suction equipment for oesophageal and tracheal suction

throat packs

lubricant

scissors

syringes

monitoring equipment:

electrocardiography (ECG)

stethoscope

oxygen and gas analyser, spirometer, airway pressure and carbon dioxide monitor

cuff pressure gauge

pulse oximetry

neuromuscular transmission monitor

arterial blood gas measurement

personal protective equipment

paediatric & adult mannequins for initial simulated assessment

modelling of industry operating conditions, including presence of situations requiring problem solving in non-routine situations

Assessors must satisfy the Standards for Registered Training Organisations (RTOs) 2015/AQTF mandatory competency requirements for assessors.


Submission Requirements

List each assessment task's title, type (eg project, observation/demonstration, essay, assingnment, checklist) and due date here

Assessment task 1: [title]      Due date:

(add new lines for each of the assessment tasks)


Assessment Tasks

Copy and paste from the following data to produce each assessment task. Write these in plain English and spell out how, when and where the task is to be carried out, under what conditions, and what resources are needed. Include guidelines about how well the candidate has to perform a task for it to be judged satisfactory.

ELEMENT

PERFORMANCE CRITERIA

Elements define the essential outcomes

Performance criteria describe the performance needed to demonstrate achievement of the element

1. Select, check and prepare airway management equipment in accordance with manufacturer’s guidelines

1.1 Review information about client and type of surgical procedure and anticipate type and calculate size of airway management equipment

1.2 Identify and respond to situations where anaesthetist needs to confirm selection

1.3 Conduct pre-use safety check of selected equipment

1.4 Diagnose airway management equipment faults and rectify within scope of role

1.5 Prepare and position equipment for use following safe manual handling techniques

2. Perform bag and mask ventilation

2.1 Position patient for bag/mask ventilation

2.2 Confirm adequate ventilation and rectify any issues preventing adequate ventilation

2.3 Insert oropharyngeal and/or nasopharyngeal airway if indicated

2.4 In consultation with the anaesthetist determine when to cease bag/mask ventilation

3. Assist with insertion of supraglottic airway devices (SAD)

3.1 Select, conduct pre-use check and prepare (SAD)

3.2 Anticipate needs of the anaesthetist

3.3 Assist with positioning of client

3.4 Provide assistance during insertion

3.5 Inflate cuff of SAD in accordance with manufacturer’s guidelines, clinical indications and anaesthetist’s directions

3.6 Secure airway into position when directed

4. Assist with insertion of endotracheal, orally or nasally and/or endobronchial tubes

4.1 Select, conduct pre-use check and prepare endotracheal or endobronchial tube and other intubation equipment

4.2 Assist with positioning of client for intubation

4.3 Anticipate needs of the anaesthetist

4.4 Provide assistance with insertion including use of stylet, bougie and/or cricoid manipulation

4.5 If applicable, inflate cuff according to industry standard.

4.6 When indicated, assist with insertion of throat pack including appropriate documentation of insertion/removal

4.7 If directed, use a stethoscope to identify breathing sounds

4.8 Secure airway into position when directed

5. Assist with rapid sequence induction

5.1 Determine rationale for rapid sequence induction

5.2 Select, conduct pre-use check and prepare equipment for rapid sequence induction

5.3 Inform client of procedures to be completed by the anaesthetic technician

5.4 Apply cricoid pressure , monitor patient for vomiting and remove pressure when instructed by the anaesthetist

5.5 Assist with insertion of endotracheal tube

5.6 Secure airway into position if directed.

6. Assist with predicted difficult airway/intubation

6.1 Discuss and confirm equipment preparation, intubation plan and contingencies with anaesthetist

6.2 Select, undertake pre-use safety checks and prepare required equipment

6.3 Inform client of tasks to be undertaken by anaesthetic technician.

6.4 Anticipate anaesthetist needs in patient preparation and assist throughout intubation

6.5 When appropriate, return clean equipment to storage location and send used equipment for processing.

6.6 Debrief with anaesthetic team on outcome of intubation.

7. Assist with connection/ disconnection of client to/from ventilation equipment

7.1 Select and prepare ventilation equipment and materials

7.2 Set ventilation modes and parameters and ensure warning devices are switched on, tested and are registering that the equipment is safe prior to use with client

7.3 Observe equipment whilst in use and take action immediately if fault develops to avoid danger to equipment, clients and staff

7.4 Follow established procedures to rectify faulty equipment

7.5 Check client’s physiological parameters when required or as directed by anaesthetist

7.6 Identify, validate and report deviations from acceptable limits of physiological parameters to the medical practitioner

7.7 Report signs of client discomfort, distress or adverse reaction to the anaesthetist

8. Assist in management of client’s airway during emergence phase

8.1 Assist anaesthetist with client positioning to facilitate management of client’s airway

8.2 Assist anaesthetist to optimise oxygenation of client

8.3 Assist with oral/nasal/endotracheal/SAD suctioning.

8.4 Assist anaesthetist as required during SAD removal or extubation and be prepared for possible reintubation

8.5 Provide reassurance to the client and take action to limit injury

8.6 Observe client’s condition throughout the procedure and take action when required or at the direction of the anaesthetist

The candidate must show evidence of the ability to complete tasks outlined in elements and performance criteria of this unit, manage tasks and manage contingencies in the context of the job role. There must be evidence that the candidate has:

followed established airway management processes and techniques including performing or assisting with at least 10 of each of the following:

pre-oxygenation

bag or mask ventiliation

Supraglottic Airway Device (SAD) insertion

oral insertion of endotracheal tubes

airway management during emergence

followed established airway management processes and techniques including performing or assisting with at least 3 of each of the following:

endobronchial tube insertion

nasal insertion of endotracheal tubes

laser tubes

rapid sequence induction

predicted difficult airway

attaching clients to ventilators

tracheostomy tube

performed or assisted with airway management on different client types of varied ages, both conscious and unconscious

responded and adapted to airway management problems:

routine

unpredictable

The candidate must be able to demonstrate essential knowledge required to effectively complete tasks outlined in elements and performance criteria of this unit, manage tasks and manage contingencies in the context of the work role. This includes knowledge of:

legal and ethical considerations (national, state/territory) for airway management, and how these are applied in organisations:

codes of practice

duty of care

infection prevention and control

informed consent

mandatory reporting

privacy, confidentiality and disclosure

records management

rights and responsibilities of workers, employers and clients

work role boundaries – responsibilities and limitations

work health and safety (WHS)

considerations for airway management in different types of surgery, including:

general/regional/local anaesthetic and sedation

remote site - radiology, electroconvulsive therapy (ECT) & endoscopy

general/gastro-intestinal surgery

ear, nose and throat surgery

gynaecological surgery

obstetric surgery

orthopaedic surgery

vascular surgery

urological surgery

oral/dental/maxillofacial surgery

cardiothoracic surgery

neurosurgery

plastic surgery

trauma/emergency surgery

ophthalmic surgery

paediatric

airway equipment, including function and operating guidelines, use, indications and limitations, and criteria for withdrawal for:

laryngoscopes blades

fibreoptic bronchoscopes

videoscopes

cricothyrotomy kits

oral and nasal airways

oral endotracheal tubes

laser tubes

nasal endotracheal tubes

tracheostomy tubes

endobronchial tubes

supraglottic airway devices

jet insufflations

intubation adjuncts – bougie, stylet, Magill’s forceps

types of suction equipment, its indication for use and hazards associated with usage

airway management procedures, common issues and scope of technician role in:

bag or mask ventilation

Supraglottic airway device insertion

insertion of endotracheal tube, orally or nasally and endobronchial tubes

rapid sequence induction

predicted difficult airway

airway management during emergence

emergency airway algorithms

gas induction

client considerations for airway management:

relationship between client positioning techniques and optimal airway management

pre-medications and their effects on respiration

causes, signs and symptoms of loss of airway

remedial actions to address loss of airway

type of surgery, including shared airway

anatomy, physiology and pathophysiology factors that impact airway management for different client groups

medical terminology specific to airway management

roles and responsibilities of those participating in the anaesthetic procedure

Australian and New Zealand College of Anaesthetists (ANZCA) Policy guidelines andDifficult airway society guidelines

The following aspects of the performance evidence must have been demonstrated in the workplace with the addition of simulations and scenarios where the full range of contexts and situations have not been provided in the workplace:

followed established airway management processes and techniques including performing or assisting with at least 10 of each of the following:

pre-oxygenation

bag or mask ventilation

SAD insertion

oral insertion of endotracheal tubes

airway management during emergence

The following aspects of the performance evidence must have been demonstrated in the workplace or in a simulated environment that reflects workplace conditions:

followed established airway management processes and techniques including performing or assisting with at least 3 of each of the following:

laser tubes

rapid sequence induction

predicted difficult airway

attaching clients to ventilators

nasal insertion of endotracheal tubes

endobronchial tube insertion

gas induction

tracheostomy tube

failed airway scenarios

The following conditions must be met for this unit:

use of suitable facilities, equipment and resources, including:

airway management equipment:

nasal and oral endotracheal tubes

tracheostomy tubes

laryngoscopes, including video, conventional, McCoy and fibreoptic

video or fibreoptic bronchoscopes

endobronchial tubes/endobronchial blockers

other difficult intubation equipment

emergency airway equipment

intubation aids (e.g. stylet, bougie, exchange catheter)

oropharyngeal/nasopharyngeal airways

Supraglottic airways

anaesthetic circuits

self inflating bag resuscitator

face masks

connectors

filters

Magill’s forceps

general medical equipment:

suction equipment for oesophageal and tracheal suction

throat packs

lubricant

scissors

syringes

monitoring equipment:

electrocardiography (ECG)

stethoscope

oxygen and gas analyser, spirometer, airway pressure and carbon dioxide monitor

cuff pressure gauge

pulse oximetry

neuromuscular transmission monitor

arterial blood gas measurement

personal protective equipment

paediatric & adult mannequins for initial simulated assessment

modelling of industry operating conditions, including presence of situations requiring problem solving in non-routine situations

Assessors must satisfy the Standards for Registered Training Organisations (RTOs) 2015/AQTF mandatory competency requirements for assessors.

Copy and paste from the following performance criteria to create an observation checklist for each task. When you have finished writing your assessment tool every one of these must have been addressed, preferably several times in a variety of contexts. To ensure this occurs download the assessment matrix for the unit; enter each assessment task as a column header and place check marks against each performance criteria that task addresses.

Observation Checklist

Tasks to be observed according to workplace/college/TAFE policy and procedures, relevant legislation and Codes of Practice Yes No Comments/feedback
 
Review information about client and type of surgical procedure and anticipate type and calculate size of airway management equipment 
Identify and respond to situations where anaesthetist needs to confirm selection 
Conduct pre-use safety check of selected equipment 
Diagnose airway management equipment faults and rectify within scope of role 
Prepare and position equipment for use following safe manual handling techniques 
Position patient for bag/mask ventilation 
Confirm adequate ventilation and rectify any issues preventing adequate ventilation 
Insert oropharyngeal and/or nasopharyngeal airway if indicated 
In consultation with the anaesthetist determine when to cease bag/mask ventilation 
Select, conduct pre-use check and prepare (SAD) 
Anticipate needs of the anaesthetist 
Assist with positioning of client 
Provide assistance during insertion 
Inflate cuff of SAD in accordance with manufacturer’s guidelines, clinical indications and anaesthetist’s directions 
Secure airway into position when directed 
Select, conduct pre-use check and prepare endotracheal or endobronchial tube and other intubation equipment 
Assist with positioning of client for intubation 
Anticipate needs of the anaesthetist 
Provide assistance with insertion including use of stylet, bougie and/or cricoid manipulation 
If applicable, inflate cuff according to industry standard. 
When indicated, assist with insertion of throat pack including appropriate documentation of insertion/removal 
If directed, use a stethoscope to identify breathing sounds 
Secure airway into position when directed 
Determine rationale for rapid sequence induction 
Select, conduct pre-use check and prepare equipment for rapid sequence induction 
Inform client of procedures to be completed by the anaesthetic technician 
Apply cricoid pressure , monitor patient for vomiting and remove pressure when instructed by the anaesthetist 
Assist with insertion of endotracheal tube 
Secure airway into position if directed. 
Discuss and confirm equipment preparation, intubation plan and contingencies with anaesthetist 
Select, undertake pre-use safety checks and prepare required equipment 
Inform client of tasks to be undertaken by anaesthetic technician. 
Anticipate anaesthetist needs in patient preparation and assist throughout intubation 
When appropriate, return clean equipment to storage location and send used equipment for processing. 
Debrief with anaesthetic team on outcome of intubation. 
Select and prepare ventilation equipment and materials 
Set ventilation modes and parameters and ensure warning devices are switched on, tested and are registering that the equipment is safe prior to use with client 
Observe equipment whilst in use and take action immediately if fault develops to avoid danger to equipment, clients and staff 
Follow established procedures to rectify faulty equipment 
Check client’s physiological parameters when required or as directed by anaesthetist 
Identify, validate and report deviations from acceptable limits of physiological parameters to the medical practitioner 
Report signs of client discomfort, distress or adverse reaction to the anaesthetist 
Assist anaesthetist with client positioning to facilitate management of client’s airway 
Assist anaesthetist to optimise oxygenation of client 
Assist with oral/nasal/endotracheal/SAD suctioning. 
Assist anaesthetist as required during SAD removal or extubation and be prepared for possible reintubation 
Provide reassurance to the client and take action to limit injury 
Observe client’s condition throughout the procedure and take action when required or at the direction of the anaesthetist 
Review information about client and type of surgical procedure and anticipate type and calculate size of airway management equipment 
Identify and respond to situations where anaesthetist needs to confirm selection 
Conduct pre-use safety check of selected equipment 
Diagnose airway management equipment faults and rectify within scope of role 
Prepare and position equipment for use following safe manual handling techniques 
Assist anaesthetist with client positioning to facilitate management of client’s airway 
Assist anaesthetist to optimise oxygenation of client 
Assist with oral/nasal/endotracheal/SAD suctioning. 
Assist anaesthetist as required during SAD removal or extubation and be prepared for possible reintubation 
Provide reassurance to the client and take action to limit injury 
Observe client’s condition throughout the procedure and take action when required or at the direction of the anaesthetist 

Forms

Assessment Cover Sheet

HLTANA003 - Assist with airway management
Assessment task 1: [title]

Student name:

Student ID:

I declare that the assessment tasks submitted for this unit are my own work.

Student signature:

Result: Competent Not yet competent

Feedback to student

 

 

 

 

 

 

 

 

Assessor name:

Signature:

Date:


Assessment Record Sheet

HLTANA003 - Assist with airway management

Student name:

Student ID:

Assessment task 1: [title] Result: Competent Not yet competent

(add lines for each task)

Feedback to student:

 

 

 

 

 

 

 

 

Overall assessment result: Competent Not yet competent

Assessor name:

Signature:

Date:

Student signature:

Date: