The additional visual aide-memoir suggested by Jennings and Bhatt [1] to further reduce the likelihood of a forgotten throat pack should be welcomed cautiously. The recently published NPSA guidelines have warned against such visual stickers as they fail to label the patient [2]. Previously, such stickers were applied to ventilator control knobs [3], monitor screens, diathermy pads but ultimately not recommended by the NPSA due to a high risk ranking. Marking the surgical assistant will never be the same as marking the patient. What if the marked person had to leave before completion of the surgery? This system relies on the assistant's ability to remember that they have a sticker on their forehead, and to wait until the end of the operation, which is not likely in this era of the European Working Time Directive.

The fundamental issue is what is the best method to mark the patient after our surgical colleagues insert a throat pack.  While awaiting a more innovative approach on labelling the patient, perhaps highlighting throat pack use on the WHO surgical checklist would be a welcome step.

Dr Nilesh Parekh

Queen Elizabeth Medical Centre

University Hospital Birmingham NHSFT

Birmingham, UK.

References:

1.           Jennings A, Bhatt V. Throatpacks: in your face?  Anaesthesia 2010; 65: 312-3.

2.           http://www.nrls.npsa.nhs.uk/resources/?entryid45=59853

3.           Stone JP, Collyer J. Aide-memoirto pharyngeal pack removal. Anesthesia and Analgesia 2003; 96: 301–8.