Human factors in complex airway management

Abstract

### Key points Human factors have been defined as ‘the environmental, organisational and job factors, and human and individual characteristics which influence behaviour at work in a way which can affect health and safety’1 and have been described with particular relevance to anaesthesia in the Anaesthetists Non-Technical Skills Framework.2 When dealing with a patient with a complex airway, exceptional attention to human factors is vital to success. This has been noted extensively in the literature after two high profile cases.3,4 Recently, there has been adoption of human factors in healthcare at the highest level with the signing of a Concordat from the National Quality Board by organizations such as the General Medical Council, The Care Quality Commission, and Health Education England.5 The Fourth National Audit Project of the Royal College of Anaesthetists (NAP4) examined major complications in airway management and concluded that poor human factors could have contributed to 40% of the cases reported. In 25% of these cases, inadequate human factors were felt to be a major contributor to a poor outcome.6 Further analysis specifically looking at human factors in cases reported to NAP4 reported that there …