D

Default approach to airway rescue : a component of an airway management strategy adopted by an organisation or department as the standard approach to airway rescue unless an alternate approach has been specifically articulated as part of the airway strategy for a particular episode of care. Reliance on the default approach to airway rescue may be appropriate either for unanticipated airway challenges or when the default strategy is felt to adequately address identified airway challenges.

Default use of a videolaryngoscope: the routine use of a laryngoscope capable of providing an indirect view of the glottis, whenever rigid laryngoscopy is undertaken, independent of whether there is an increased risk of challenges arising with tracheal intubation or an intention to perform direct laryngoscopy. The feasibility of adopting such an approach requires adequate availability of equipment and staff training.

Other terms in use which would be considered synonymous to ‘default use of a videolaryngoscope’ include routine videolaryngoscopy, default videolaryngoscopy and universal videolarynoscopy. These terms have not been adopted for PUMA as they fail to clearly differentiate between the routine use of a videolaryngoscope (device) and the routine use of videolarygoscopy (technique) when the former may in fact be undertaken without the latter when using a Macintosh blade, so as to augment both the safety and efficacy of the acquisition and maintenance of direct laryngoscopy skills. The term ‘universal videolaryngoscopy’ is avoided in particular as it may be misinterpreted as implying indiscriminate use of a videolaryngoscopy for all tracheal intubations, even when other techniques (e.g. awake tracheal intubation with a flexible bronchoscope) are indicated.

Difficult airway response team: team of skilled airway practitioners from a spectrum of backgrounds, often including anesthetists, ENT surgeons and airway assistants who can be rapidly deployed to areas where specialised airway management is urgently required, in response to an airway code.