Application
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.
Elements and Performance Criteria
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 |
Evidence of Performance
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
Evidence of Knowledge
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 and
Assessment Conditions
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.
Foundation Skills
The Foundation Skills describe those required skills (employability skills, language, literacy and numeracy) that are essential to performance. |
Foundation skills essential to performance are explicit in the performance criteria of this unit of competency. |