National Ambulance Service Airway Management Audit
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Welcome
Welcome to the National Ambulance Service Airway Management Audit. The audit aims to identify the airway management equipment that is currently available to those responding to calls on emergency vehicles in UK NHS Ambulance Services. It also aims to identify the qualifications required by practitioners to utilise different airway skills and to identify what factors are considered by Ambulance Services when procuring equipment and deciding which level of practitioner can utilise which skill.
We are aware that there is some inconsistency regarding titles of practitioner so we have referred to those that appear to be in most common use. We also refer to "Emergency Vehicles" and by this we are referring to land-based vehicles to include Rapid Response Vehicles (car and motorcycle) and Ambulance Vehicles equipped to transport patients. If you have any questions regarding the terminology used, please contact the project lead, Mr. Pete Gregory, who will be happy to discuss this with you.
Although we ask for the name of your organisation, nobody other than the project team will be allowed to see the unanonymised results of your responses and no information about your individual Service will be made available to anyone outside of the project team. The results of the audit will be published in at least one medical journal and may also be presented at medical conferences. However, the results of the audit will be anonymised before publication or presentation, and no one will be able to identify information about any individual Service that took part in the audit.
The information gleaned from this audit will be invaluable in understanding what is happening relating to airway management in UK Ambulance Services and it will provide data that can help to inform future practice.
The audit questionnaire takes around 15-20 minutes to complete and can be saved part way through. A little more time may be required if the answers are not immediately known.
Many thanks for your time in completing this questionnaire.
Note that once you have clicked on the CONTINUE button at the bottom of each page you can not return to review or amend that page
The Project Team
Project Lead
Pete Gregory, Senior Lecturer in Paramedic Practice, Coventry University, Warwickshire, United Kingdom.
Contact details:
Tel: 02476 795912
Email:
Project Team
Dr. Tim Kilner, Principal Lecturer in Paramedic Practice, Coventry University, Warwickshire, United Kingdom
Sally Arnold-Jones, Lecturer in Paramedic Practice, Coventry University, Warwickshire, United Kingdom
Professor Malcolm Woollard, Visiting Professor at University of Surrey, Surrey, United Kingdom
If you have any questions or concerns related to this project, please contact Pete Gregory.
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National Ambulance Service Airway Management Audit
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Your Ambulance Service
Top of Form
About the Service
1.Which Ambulance Service are you responding on behalf of? (Please click "more info" for further information)East Midlands Ambulance Service
East of England Ambulance Service
Isle of Wight Ambulance Service
London Ambulance Service
North East Ambulance Service
North West Ambulance Service
Northern Ireland Ambulance Service
Scottish Ambulance Service
South Central Ambulance Service
South East Coast Ambulance Service
South Western Ambulance Service
Welsh Ambulance Service
West Midlands Ambulance Service
Yorkshire Ambulance Service
2.Would you please provide your name, your position in the organisation and your contact details? (Please click "more info" for further information)
3.Which of the following staff grades do you employ on emergency vehicles in your Service? Please note, student paramedics may or may not be employed by the Service but if they work operationally on Service emergency vehicles please tick the box. (Please click "more info" for further information)
(select all that apply)
Emergency Care Assistant (or equivalent)
Emergency Medical Technician
Paramedic
Emergency Care Practitioner (or equivalent)
Critical Care Paramedic
Student paramedic
Nurse
Doctor
Other(please specify):
National Ambulance Service Airway Management Audit
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Basic Airway Adjuncts
This section looks at Oropharyngeal (OPA) and Nasopharyngeal (NPA) airways.
Top of Form
Oropharyngeal Airways
4.Does your Service provide Oropharyngeal Airways(OPA) to some/all staff employed on emergency vehicles?
Yes
No
5.Which grades of staff does your Service allow to use OPAs?
(select all that apply)
Emergency Care Assistant (or equivalent)
Emergency Medical Technician
Paramedic
Emergency Care Practitioner (or equivalent)
Critical Care Paramedic
Student paramedic
Nurse
Doctor
Other(please specify):
6.Please indicate what size OPA is/are available in your Service
(select all that apply)
000
00
0
1
2
3
4
5
6
All of the above
7.In question 4 you identified the grades of staff that are allowed to use OPAs. Are all clinical grades allowed to use the full range of sizes that are provided by your Service?
Yes
No
Please identify what restrictions you place upon which practitioner and the reason for that restriction.
Nasopharyngeal Airways
8.Does your Service provide Nasopharyngeal Airways (NPA) to some/all staff employed on emergency vehicles?Yes
No
9.Which grades of staff does your Service allow to use NPAs?
(select all that apply)
Emergency Care Assistant (or equivalent)
Emergency Medical Technician
Paramedic
Emergency Care Practitioner (or equivalent)
Critical Care Paramedic
Student paramedic
Nurse
Doctor
Other(please specify):
10.Please indicate what size NPA is/are available in your Service (sizes refer to internal diameters)
(select all that apply)
6 mm
7 mm
8 mm
9 mm
All of the above
11.In question 8 you identified the grades of staff that are allowed to use NPAs. Are all clinical grades allowed to use the full range of sizes that are provided by your Service?
Yes
No
Please identify what restrictions you place upon which practitioner and the reason for that restriction.
12.What techniques and equipment does your Service advocate for use when managing nasal bleeding resulting from the insertion of an NPA? Please comment upon bleeding in the anterior and posterior nares.
National Ambulance Service Airway Management Audit
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Supraglottic Airways
This section looks at Service provision related to supraglottic airways. Please answer all relevant questions.
Top of Form
Laryngeal Mask Airway
13.Does your Service provide Laryngeal Mask Airways (LMA) to some/all staff employed on emergency vehicles?Yes
No
If no, why are LMAs not used in your Service?
14.Which grades of staff does your Service allow to use LMAs?
(select all that apply)
Emergency Care Assistant (or equivalent)
Emergency Medical Technician
Paramedic
Emergency Care Practitioner (or equivalent)
Critical Care Paramedic
Student paramedic
Nurse
Doctor
Other(please specify):
15.Please indicate what size LMA is/are available in your Service
(select all that apply)
1
1.5
2
2.5
3
4
5
6
All of the above
16.In question 13 you identified the grades of staff that were allowed to use LMAs. Are all of those clinical grades allowed to use the full range of sizes that are provided by your Service?
YesNo
If no, please identify what restrictions you place upon which practitioner and the reason for that restriction.
17.Which of the following LMA devices are issued in your Service?
(select all that apply)
LMA Classic
LMA Unique
LMA Fastrach
LMA Flexible
LMA Proseal
LMA Supreme
Intubating LMA
I-Gel
Other(please specify):
18.Are all of the LMAs issued in your Service single-use?
Yes
No
If your Service provides multiple-use LMA devices, how is sterility ensured?
19.Which of the following factors influenced the Service's purchasing decision?
(select all that apply)
Price of device
Quality of device
Effectiveness of device (as supported by the literature)
Clinician request
Other(please specify):
Which was the most important factor in the purchasing decision?
Other Supraglottic devices
20.Besides the LMA does your Service provide any other supraglottic device?If you answer no, please go to question 25Yes
No
21.Which of the following supraglottic devices are available within your Service?
(select all that apply)
Combitube
Laryngeal Tube Airway
Other(please specify):
22.Which staff grades does your Service allow to use these other supraglottic devices?
(select all that apply)
Emergency Care Assistant (or equivalent)
Emergency Medical Technician
Paramedic
Emergency Care Practitioner (or equivalent)
Critical Care Paramedic
Student Paramedic
Nurse
Doctor
All of the above
Other(please specify):
23.What size Laryngeal Tube Airway is/are available in your Service?
(select all that apply)
3
4
5
All of the above
24.If you are using a supraglottic device other than an LMA, which of the following factors influenced the Service's purchasing decision?
(select all that apply)
Price of device
Quality of device
Effectiveness of device (as supported by the literature)
Clinician request
Other(please specify):
Which was the most important factor in the purchasing decision?
National Ambulance Service Airway Management Audit
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Tracheal Intubation
This section looks at service provision related to tracheal intubation. Please answer all relevant questions.
Top of Form
Tracheal Intubation
25.Does your Service allow some/all practitioners to undertake tracheal intubation?Yes
No
How does your Service ensure that those who are permitted to perform tracheal intubation remain skilled in the practice?
26.Please explain why your Service either allows or disallows tracheal intubation. If your Service does not allow practitioners to intubate, please move to question 38 on completion of this question.
27.Which grades of practitioner does your Service allow to practice tracheal intubation?
(select all that apply)
Emergency Care Assistant (or equivalent)
Emergency Medical Technician
Paramedic
Emergency Care Practitioner (or equivalent)
Critical Care Paramedic
Student Paramedic
Nurse
Doctor
Other(please specify):
28.Please indicate what size tracheal tube is/are available in your Service
(select all that apply)
2.5
3
3.5
4
4.5
5
5.5
6
6.5
7
7.5
8
8.5
9
9.5
10
All of the above
29.In question 25 you identified the grades of practitioner that are allowed to practice tracheal intubation. Are all those clinical grades who are allowed to practice tracheal intubation allowed to use the full range of tube sizes that are provided by your Service?
Yes
No
If no, please identify what restrictions you place upon which practitioner and the reason for that restriction.
30.Which of the following devices does your Service use to facilitate difficult intubation / intubation with a poor view of the glottic opening?
(select all that apply)
Single patient use bougie with a coudé tip
Reusable bougie with a coudé tip
Single patient use bougie with a straight tip
Reusable bougie with a straight tip
Malleable stylet
Neither bougie nor stylet provided
Other(please specify):
31.Does your Service advocate the use of bougies for intubation of children over the age of 8 years?
Yes
No
32.Are the laryngoscope blades issued by your Service:
Single-use
Reusable
A combination of single-use and reusable
Please explain which blades are single-use and which are reusable and why this decision was taken.
33.What type of laryngoscope blades does your Service advocate for the intubation of infants?
(select all that apply)
Macintosh
Miller
McCoy
Magill
Other(please specify):
34.What type of laryngoscope blade does your Service advocate for the intubation of young children (less than 8 years of age)?
(select all that apply)
Macintosh
Miller
McCoy
Magill
Other(please specify):
35.What type of laryngoscope blade does your Service advocate for the intubation of adults?
(select all that apply)
Macintosh
Miller
McCoy
Magill
Other(please specify):
36.Which of the following methods does your Service use to confirm placement of a tracheal tube?
(select all that apply)
Garphical waveform capnography
Non-graphical waveform capnography
Colorimetric capnometry
Oesophageal bulb detector
Oesophageal syringe detector
Chest auscultation
Other(please specify):
37.Does your Service provide any novel devices for tracheal intubation such as the Airtraq Laryngoscope
Yes
No
If yes, what other devices are available within your Service?
National Ambulance Service Airway Management Audit
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Airway Clearance
This section refers to equipment used for clearing an airway.
Top of Form
Suction Devices
38.Which of the following types of suction unit is/are available in your Service?(select all that apply)
Hand operated manual suction device
Battery operated portable suction device
Vehicle based suction device
39.For each of the suction devices you have indicated above, please specify the make and model most commonly provided within your Service.
40.Which of the following suction adjuncts does your Service provide?
(select all that apply)
Yankauer catheter
Soft suction catheter
Large bore suction catheter
Other(please specify):
Intubation Forceps
41.Does your Service provide Magill Forceps to those who are allowed to practice laryngoscopy?Yes
No
If no, what other device do you provide for this purpose?
42.Does your Service provide Magill forceps suitable for use on young children to those who are allowed to practice laryngoscopy?
Yes
No
National Ambulance Service Airway Management Audit
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Surgical Airway
This section relates to the provision of a surgical airway
Top of Form
Cricothyroidotomy
43.Does your Service allow certain staff grades to perform needle cricothyroidotomyYes
No
If yes, which practitioners are allowed to perform the technique?(select all that apply)
Emergency Care Assistant (or equivalent)
Emergency Medical Technician
Paramedic
Emergency Care Practitioner (or equivalent)
Critical Care Paramedic
Student Paramedic
Nurse
Doctor
Other(please specify):
44.Does your Service allow certain staff grades to perform surgical cricothyroidotomy
Yes
No
If yes, which grades of staff are allowed to perform the technique?(select all that apply)
Emergency Care Assistant (or equivalent)
Emergency Medical Technician
Paramedic
Emergency Care Practitioner (or equivalent)
Critical Care Paramedic
Student Paramedic
Nurse
Doctor
Other(please specify):