FRCA Notes


Throat Packs


  • A 2009 National Patient Safety Agency report shone the spotlight on throat packs, with a series of recommendations to reduce the risk associated with their use
  • Seeing as a retained throat pack is a never event, and the airway is the anaesthetist's domain, these risk-reducing steps are fair exam game
  • Given their risk, the use of a throat pack should be justified - most indications are surgical

  • These include:
    • To prevent air leak e.g. in paediatric patient with uncuffed tube
    • To absorb blood and prevent formation of 'coroner's clot'
    • To prevent GI absorption of blood and subsequent PONV
    • To absorb/catch debris to prevent soiling of lower airway or causing airway obstruction at extubation
    • To facilitate surgical access, haemostasis or airway protection
    • To absorb liquid nasal vasoconstrictors

  • Avoid the use of throat pack altogether!

  • Should be inserted by the surgeon and removed by the same individual
  • Should have two forms of confirmation of placement, for example a combination of:
    • Visual prompt e.g. sticker on patient's forehead, or on the airway
    • Documentary evidence e.g. insertion and removal recorded on swab count board, or anaesthetic chart
  • Two - person confirmation of insertion and removal
  • Attach the pack to the artificial airway
  • Leave part of the pack protruding so it is visible