“Enhancing the Performance of Emergency Airway Management within the Tactical Environment”
An Emergency Airway Bag that provides a structured reproducible approach to emergency airway management in the tactical environment.
SCRAM™ enhances the performance of airway management by focusing on process improvement through design. Systemisation, standardisation, cognitive offloading, human factors and good governance are core principles to the design and philosophy of SCRAM™. Whereas most other manufacturers focus on the storage and transportation of equipment.
The initial resuscitation and evaluation of critically injured or ill patients begins in the pre-hospital environment, and the care that they receive can have a major influence on subsequent outcome.1,2 Providing individualised, tailored care based on injury patterns, means that some patients may require specialised care, such as pre-hospital emergency Anaesthesia (PHEA) to optimize their clinical condition prior to transfer.3
Cognitive load, systemisation, appropriately trained personnel using a well-rehearsed approach with standardised equipment and a good governance structure are fundamental components of safe, effective and timely emergency airway management.4
|“Enhancing the Performance of Emergency Airway Management within the Tactical Environment”
The structure of Tactical SCRAM™ was developed using the principles of Tactical Combat Casualty Care5 and Battlefield Advanced Trauma Life Support (BATLS).
Care is divided into 3 phases based on the location relative to the threat:5
The design was then developed by mapping the airway interventions within each of the phases of care, reviewing current evidence,6-12 and focusing on:
Airway-related complications significantly increase as the number of laryngoscopic attempts increase.13 Airway contamination is one of the major causes of failure in first pass tracheal intubation attempts.14 Blood and vomitus in the airway have been identified as a predictor of difficult intubation.15-18 Yet, decontamination of the airway is a poorly defined step in airway management.19
With this in mind, we have included the SEADUC™ with DuCanto Catheter® into the design of Tactical SCRAM™.
|“Designed to enhance the performance of emergency airway management within the tactical environment”
There are several ways of reducing cognitive load in critical situations, including the development of strategies such as briefings, flows (workflow patterns), and checklists and limiting the number of critical decisions that need to be made. The cognitive burden can potentially be further reduced by standardising the equipment and processes required for the intervention, for example by streamlining packaging or numbering various components sequentially. Such improvements could enhance patient safety by contributing to greater reliability, resilience and situational awareness.3, 20
Hick’s Law (or the Hick-Hyman Law)21 is named after a British and an American psychologist team of William Edmund Hick and Ray Hyman. In 1952, this pair set out to examine the relationship between the number of stimuli present and an individual’s reaction time to any given stimulus. As you would expect, the more stimuli to choose from, the longer it takes the user to make a decision on which one to interact with.21 So, the more choices you have or the harder the choices are, the longer it takes for you to make a decision and the more likely you’ll experience information overload. Hick’s Law can help us reduce that complexity by simplifying the decision-making process.
Planning and preparation of equipment are important components of emergency airway management. Poor planning and interrupted workflow at preparation (kit dump) stage of are significant contributors to morbidity and mortality,20 stressing the importance of systemisation, standardisation and cognitive offloading.3
|“SCRAM™ seamlessly integrates into any airway management strategy”
Openhouse products are the manufactures SCRAM™ work with Scottish Health Innovations Ltd. (SHIL) and the inventors to bring you SCRAM™. Openhouse of have a reputation for high quality craftsmanship with 30 years experience manufacturing bespoke textile products for medical teams around the world.