By Tolli Willhite Few things in life leave us more vulnerable than having surgery. Our loved ones give us one last smile and a reassuring squeeze of the hand as we’re wheeled down the hall. We’re quite literally placing our lives in the hands of trusted surgeons, anesthesia professionals and a host of specially trained staff. These people are the ones we’re counting on to use all their training, experience and equipment should something go wrong—such as difficulty establishing an airway. Kootenai Health prepares and trains for exactly this situation. In 2020, Kootenai Health started the Difficult Airway Response Team (DART) program, a multidisciplinary task force led by Sarah Pierce, a certified registered nurse anesthetist at Anesthesia Associates of Coeur d’Alene and medical director of the DART program. After securing leadership support and funding, the team first carefully selected standardized airway equipment to be assembled in a fleet of DART carts. The carts are identical and placed throughout the hospital, so no matter where a response is needed, the same equipment is always available. Education is key “Rollout of the equipment required significant communication and education to increase awareness and familiarity with the equipment,” explained Sarah. Training is a key element of successfully implementing the DART program. Annual workshops are held to train staff on the contents of the DART carts, difficult airway scenarios, identifying high-risk patients and how to create surgical airways in emergency situations. The workshops attract providers, specialists and first responders from throughout the region, with additional outreach to area hospitals. Representatives from many different disciplines attend, including intensivists, ENT (ear, nose and throat) surgeons, emergency department physicians, anesthesia providers, trauma surgeons, nurses, respiratory therapists, paramedics and Life Flight personnel. Health care can be described as a team sport. Everyone has a position to play and a job to do. “We need to be able to train together, recognize each other’s strengths and limitations, understand how to perform as a collective team, know when to ask for help, and communicate effectively,” Sarah said to describe the annual workshops. “There has been a profound improvement in our collaborative culture and in patient safety,” Sarah explained. “Providers are more likely to reach out to anesthesia professionals with a potentially difficult airway Otolaryngologist Chad McCormick, M.D. (far right), instructs a practice simulation for airway emergencies. Otolaryngologist Erik Gilbert, M.D., demonstrates a nasopharyngeal airway insertion. “There has been a profound improvement in our collaborative culture and in patient safety.” BREATHE EASY—You’re in Good Hands situation, do so early, and use a team approach for securing the airway.” The international Anesthesia Patient Safety Foundation has recognized the DART program at Kootenai Health as a cutting-edge service that fosters collaboration to provide the highest level of patient care. As a patient, you can breathe easy—because you know you’re in good hands. KH.ORG 5
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