Kidd L R, Wegrzynek P, Newell C, Wainwright E
Department of Anaesthesia, Gloucestershire Hospitals NHS Foundation Trust Gloucester UK.
Bath Spa University Bath UK.
Anaesth Rep. 2024 Oct 7;12(2):e12331. doi: 10.1002/anr3.12331. eCollection 2024 Jul-Dec.
Emergency front of neck airway (eFONA) is a potentially lifesaving but very high-stress procedure. We explored the cognitive and affective processes involved via semi-structured interviews with 17 UK anaesthetists who had attempted eFONA within the previous two years. Thematic analyses generated two meta-themes: 'Making the decision is the hardest part; the doing is easier' and 'What helps make the decision?'. We found concerns around scrutiny, lack of a flat hierarchy, unfamiliarity with the situation and the lack of a model for transitioning to eFONA. Culture change, using a shared mental model, priming and emotional disengagement, assisted with eFONA decision-making. Conclusions and implications for practice are presented.
紧急颈部前方气道建立（eFONA）是一种可能挽救生命但压力极大的操作。我们通过对17名在过去两年内尝试过eFONA的英国麻醉医生进行半结构化访谈，探索了其中涉及的认知和情感过程。主题分析产生了两个元主题：“做决定是最困难的部分；实际操作更容易”以及“哪些因素有助于做出决定？”。我们发现了对审查、缺乏扁平层级结构、对情况不熟悉以及缺乏向eFONA过渡的模型等方面的担忧。文化变革、使用共享心理模型、启动和情感脱离有助于eFONA决策制定。文中呈现了对实践的结论和启示。
