Systematic review of benefits or harms of routine anaesthetist-inserted throat packs in adults: practice recommendations for inserting and counting throat packs: An evidence-based consensus statement by the Difficult Airway Society (DAS), the British Association of Oral and Maxillofacial Surgery (BAOMS) and the British Association of Otorhinolaryngology, Head and Neck Surgery (ENT-UK)

V. Athanassoglou, A. Patel, B. McGuire, A. Higgs, M. S. Dover, P. A. Brennan, A. Banerjee, B. Bingham, J. J. Pandit (Lead / Corresponding author)

    Research output: Contribution to journalReview article

    5 Citations (Scopus)

    Abstract

    Throat packs are commonly inserted by anaesthetists after induction of anaesthesia for dental, maxillofacial, nasal or upper airway surgery. However, the evidence supporting this practice as routine is unclear, especially in the light of accidentally retained throat packs which constitute 'Never Events' as defined by NHS England. On behalf of three relevant national organisations, we therefore conducted a systematic review and literature search to assess the evidence base for benefit, and also the extent and severity of complications associated with throat pack use. Other than descriptions of how to insert throat packs in many standard texts, we could find no study that sought to assess the benefit of their insertion by anaesthetists. Instead, there were many reports of minor and major complications (the latter including serious postoperative airway obstruction and at least one death), and many descriptions of how to avoid complications. As a result of these findings, the three national organisations no longer recommend the routine insertion of throat packs by anaesthetists but advise caution and careful consideration. Two protocols for pack insertion are presented, should their use be judged necessary.

    Original languageEnglish
    Pages (from-to)612-618
    Number of pages7
    JournalAnaesthesia
    Volume73
    Issue number5
    Early online date10 Jan 2018
    DOIs
    Publication statusPublished - 1 May 2018

    Keywords

    • Journal article
    • Review
    • Airway management
    • Human factors
    • Never events
    • Patient safety
    • Risk management
    • risk management
    • Never Events
    • patient safety
    • airway management
    • human factors

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