In the News
Keeping Pace with Change
Outpatient Surgery Magazine, January 2021, pg 62-63.
Roxanne McMurray, DPN, APRN, CRNA and founder of McMurray Medical shares important considerations for outpatient providers, including the need for improved airway management. Read full article
McMurray R, Gordon L. A Survey of Provider Satisfaction of a New, Flexible Extended-Length Pharyngeal Airway to Relieve Upper Airway Obstruction during Deep Sedation. Enliven: J Anesthesiol Crit Care Med. 2021;8(2):002.
MEA use-assessment survey study involved 54 anesthesia providers from 15 U.S. surgery locations. Providers were instructed on MEA use and trialed the airway in adult patients experiencing an upper airway obstruction under deep sedation/MAC. Results include:
100% successful in establishing and maintaining a patent airway (n=86)
93% of respondents agreed that the MEA was easy to place
98% allowed for a “hands-off approach"
86% would improve airway management practice and patient outcomes
This pilot study demonstrated that the novel extended airway is an effective and satisfactory method for anesthesia providers to alleviate airway obstruction during deep sedation
Airway Management for Deep Sedation
McMurray R, Becker L, Frost Olsen K, McMurray M. Airway Management for Deep Sedation: Current Practice, Limitations, and Needs as Identified by Clinical Observation and Survey Results. AANA J. 2020, 88(2):123- 129.
A clinical observation study (n=243) and an electronic provider survey (n=293) were conducted to examine the practices related to airway management in deep sedation/monitored anesthesia care (MAC). The clinical observation study objective was to investigate reported postoperative sore throat (POST) occurrence associated with use of either a non-traditional airway (nasal airway used orally) or traditional oral airways (TOAs) in deep sedation procedures. Patients receiving non-traditional airways reported significantly (P<.001) less POST. These results prompted a broader exploration into deep sedation airway practices of anesthesia providers via an electronic survey. The majority of respondents to the electronic survey (n=293) reported adverse effects including gagging/coughing upon insertion, oral cavity injury and bleeding with TOAs. A noteworthy subgroup of the electronic group (52.8%) reported using nasal airways orally to avoid adverse effects associated with TOAs. Investigation outcomes suggest a clinical void in current airway management options for deep sedation. Results indicate providers' interests in airway devices that maintain a patent airway while mitigating adverse effects associated with commonly used traditional airways.
Innovative Airway for Deep Sedation/MAC: A New Solution
McMurray R. Innovative airway for deep sedation/MAC: A new solution. The McMurray Enhanced Airway (MEA). Trends in Anesthesia and Critical Care. February 2020.
Anesthesia providers at two different hospitals completed 62 surveys, providing feedback on the McMurray Enhanced Airway (MEA). Of the respondents, 100% reported that the MEA would improve their airway management practice and positively impact patient care. All of the respondents reported that they would recommend the MEA for use in the following ways: for deep sedation/monitored anesthesia care (MAC) airway management, for intraoral ventilation, to help decrease fire risk associated with oxygen delivery, and to prevent collapsing of the laryngeal mask airway (LMA). Of the survey respondents, 95% stated they would use the MEA to prevent collapsing of the endotracheal tube (ETT).
Innovative Airway for Deep sedation/MAC
McMurray R. Innovative airway for deep sedation/MAC: A new solution. The McMurray Enhanced Airway. 2nd World Airway Management Meeting 2019 poster presentation 325. E-Poster presentation
Deep monitored anesthesia care (MAC) administration is increasing and offers patient comfort while preserving spontaneous ventilation. Establishing a patent airway is essential to avoid adverse outcomes from inadequate ventilation and oxygenation—the source in more than a quarter of reported MAC anesthesia closed claims. Pharyngeal airways are often needed. Yet, anesthesia providers often must implement chin lift or jaw thrust to alleviate redundant tissue obstruction. These maneuvers can provoke pain for both patients and providers. Workarounds in airway management have emerged in order to displace redundant pharyngeal soft tissue and improve ventilation and respiratory outcomes. To avoid these workarounds, some of which involve off-label practices of nasal airways used orally, and to provide a needed solution, the McMurray Enhanced Airway (MEA) was developed. To obtain feedback of the MEA, 62 surveys were completed by anesthesia providers at two different hospitals. Of the respondents,100% reported that the MEA would improve their airway management practice and positively impact patient care. Based on the survey data from the first clinical use, the MEA fills a gap in airway management to improve ventilation and respiratory outcomes. The MEA can also aid in intraoral ventilation for challenging-to-ventilate patient populations.
Airway Management for Deep Sedation/MAC
McMurray R, Becker L, Frost Olsen K, McMurray M. Airway Management for Deep Sedation/MAC: Current Practice, Associated Outcomes, Limitations, and Needs as Identified by Survey Results. AANA.com, AANA Foundation 2019 Poster Abstracts, A2. Abstract on page 2 | E-poster
Anesthesia administration is increasing outside the hospital OR for many reasons. Pharyngeal airways are often needed but are associated with adverse outcomes. There is an emerging trend to place nasal airways orally to circumvent some of these adverse events. An electronic survey examining the use of pharyngeal airways in anesthesia procedures was created to identify potential needs in airway management relative to current practice.