How China anesthesiologists document and communicate difficult airway management.
Airway management
Difficult airway
Notification
Questionnaire
Journal
BMC anesthesiology
ISSN: 1471-2253
Titre abrégé: BMC Anesthesiol
Pays: England
ID NLM: 100968535
Informations de publication
Date de publication:
29 Oct 2024
29 Oct 2024
Historique:
received:
09
07
2023
accepted:
23
09
2024
medline:
30
10
2024
pubmed:
30
10
2024
entrez:
30
10
2024
Statut:
epublish
Résumé
According to the Chinese Society of Anesthesiology, it is recommended that patients with difficult airways be documented and notified, which will provide healthcare professionals with a direct reference when managing airways. However, compliance with this initiative remains unclear. This study was conducted to investigate the current status and need for difficult airway notification at Plastic Surgery Hospital and to explore the factors contributing to noncompliance. Anesthesiologists, surgeons, and patients in Plastic Surgery Hospital were administered separate questionnaires regarding notification of difficult airway management. Participants were surveyed regarding their attitudes and current practices regarding difficult airway notification. In addition, questions were asked regarding the barriers that contribute to noncompliance. A total of 632 valid responses were obtained and analyzed, giving a response rate of 99.21%. 399 patients (89.46%) felt it was very important for anesthesiologists to inform them about their difficult airway, and 91.03% felt it was very important for them to receive a letter of their airway assessment. However, twenty-two anesthesiologists (64.7%) reported verbally informing less than 50% of patients about their difficult airway after surgery, and only four anesthesiologists informed all patients they encountered. Most surgeons (91.22%) and anesthesiologists (91.18%) believe that it is vital to inform patients verbally, while 114 surgeons (77.03%) and 31 anesthesiologists (91.18%) believe that it is essential to complete a difficult airway notification alert. Among the factors causing noncompliance, 17 (34.69%) believed that absence of mandatory rules, 9 (18.37%) believed that increased workload, and 8 (16.33%) believed that notification methods were lacking. The compliance to difficult airway notification remains low in Plastic Surgery Hospital despite the high incidence of difficult airways. Although anesthesiologists, surgeons, and patients are strongly in favor of it. Among the barriers to compliance were the absence of a well-developed notification system and a means of notification such as an alert form for difficult airways. This may spur the anesthesiology society to publish the notification system.
Sections du résumé
BACKGROUND
BACKGROUND
According to the Chinese Society of Anesthesiology, it is recommended that patients with difficult airways be documented and notified, which will provide healthcare professionals with a direct reference when managing airways. However, compliance with this initiative remains unclear. This study was conducted to investigate the current status and need for difficult airway notification at Plastic Surgery Hospital and to explore the factors contributing to noncompliance.
METHODS
METHODS
Anesthesiologists, surgeons, and patients in Plastic Surgery Hospital were administered separate questionnaires regarding notification of difficult airway management. Participants were surveyed regarding their attitudes and current practices regarding difficult airway notification. In addition, questions were asked regarding the barriers that contribute to noncompliance.
RESULTS
RESULTS
A total of 632 valid responses were obtained and analyzed, giving a response rate of 99.21%. 399 patients (89.46%) felt it was very important for anesthesiologists to inform them about their difficult airway, and 91.03% felt it was very important for them to receive a letter of their airway assessment. However, twenty-two anesthesiologists (64.7%) reported verbally informing less than 50% of patients about their difficult airway after surgery, and only four anesthesiologists informed all patients they encountered. Most surgeons (91.22%) and anesthesiologists (91.18%) believe that it is vital to inform patients verbally, while 114 surgeons (77.03%) and 31 anesthesiologists (91.18%) believe that it is essential to complete a difficult airway notification alert. Among the factors causing noncompliance, 17 (34.69%) believed that absence of mandatory rules, 9 (18.37%) believed that increased workload, and 8 (16.33%) believed that notification methods were lacking.
CONCLUSIONS
CONCLUSIONS
The compliance to difficult airway notification remains low in Plastic Surgery Hospital despite the high incidence of difficult airways. Although anesthesiologists, surgeons, and patients are strongly in favor of it. Among the barriers to compliance were the absence of a well-developed notification system and a means of notification such as an alert form for difficult airways. This may spur the anesthesiology society to publish the notification system.
Identifiants
pubmed: 39472793
doi: 10.1186/s12871-024-02739-8
pii: 10.1186/s12871-024-02739-8
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
390Informations de copyright
© 2024. The Author(s).
Références
Asai Takashi. Video laryngoscopes: do they truly have roles in difficult airways? Anesthesiology. 2012;116: 515 – 17.
Apfelbaum JL, Hagberg CA, Caplan RA, Blitt CD, Connis RT, Nickinovich DG, et al. Practice guidelines for management of the difficult airway: an updated report by the American Society of Anesthesiologists Task Force on Management of the difficult Airway. Anesthesiology. 2013;118:251–70.
doi: 10.1097/ALN.0b013e31827773b2
pubmed: 23364566
Frerk C, Mitchell VS, McNarry AF, Mendonca C, Bhagrath R, Patel A, et al. Difficult Airway Society intubation guidelines working group. Difficult Airway Society 2015 guidelines for management of unanticipated difficult intubation in adults. Br J Anaesth. 2015;115:827–48.
doi: 10.1093/bja/aev371
pubmed: 26556848
pmcid: 4650961
Ma WH, Deng XM, Zuo MZ. The guidelines for management of the difficult airway. In: Xiong LZ, Deng XM, editors. Chinese Anesthesiology guidelines and Expert Consensus. Beijing: People’s Medical Publishing House; 2017. p. 49.
Piepho T, Cavus E, Noppens R, Byhahn C, Dörges V, Zwissler B, et al. S1 guidelines on airway management: guidelines of the German society of Anesthesiology and Intensive Care Medicine. Anesthetist. 2015;64:27–40.
doi: 10.1007/s00101-015-0109-4
Myatra SN, Shah A, Kundra P, Patwa A, Ramkumar V, Divatia JV, et al. All India Difficult Airway Association 2016guidelines for the management of unanticipated difficult tracheal intubation in adults. Indian J Anaesth. 2016;60:885–98.
doi: 10.4103/0019-5049.195481
pubmed: 28003690
pmcid: 5168891
Japanese Society of Anesthesiology. JSA airway management guideline 2014: to improve the safety of induction of anesthesia. J Anesth. 2014;28:482–93.
doi: 10.1007/s00540-014-1844-4
Law JA, Broemling N, Cooper RM, Drolet P, Duggan LV, Griesdale DE, et al. The difficult airway with recommendations for management – part 1 – difficult tracheal intubation encountered in an unconscious/induced patient. Can J Anesth. 2013;60:1089–118.
doi: 10.1007/s12630-013-0019-3
pubmed: 24132407
Higgs A, McGrath BA, Goddard C, Rangasami J, Suntharalingam G, Gale R, et al. Guidelines for the management of tracheal intubation in critically ill adults. Br J Anaesth. 2018;120:323–52.
doi: 10.1016/j.bja.2017.10.021
pubmed: 29406182
Myatra SN, Ahmed SM, Kundra P, Garg R, Ramkumar V, Patwa A, et al. The all India difficult airway association 2016 guidelines for tracheal intubation in the intensive care unit. Indian J Anaesth. 2016;60:922–30.
doi: 10.4103/0019-5049.195481
pmcid: 5168895
Frerk C, Cook TM. Management of the can’t intubate can’t ventilate situation and the emergency surgical airway. In: 4th National Audit Project of the Royal College of Anaesthetists: Major complications of airway management in the UK. The Royal College of Anaesthetists and the Difficult Airway Society. 2011. https://www.nationalauditprojects.org.uk/downloads/NAP4 Full Report. Accessed 30 March 2016.
Xue FS, Liu YY, Li HX. Difficult Airway Management Strategies - Current issues and future directions. J Clin Anesthesiology. 2018;34:89–91.
Deng XM, Zeng YM, Huang YG. Miller’s Anesthesia. Beijing: Peking University Medical Press; 2016. p. 1489.
Ramachandran SK, Mathis MR, Tremper KK, Shanks AM, Kheterpal S. Predictors and clinical outcomes from failed laryngeal mask airway Unique™. A study of 15,795 patients. Anesthesiology. 2012;116:1217–26.
doi: 10.1097/ALN.0b013e318255e6ab
pubmed: 22510864
Barron FA, Ball DR, Jefferson P, Norrie J. Airway alerts’. How UK anaesthetists organise, document and communicate difficult airway management. Anaesthesia. 2003;58:73–7.
doi: 10.1046/j.1365-2044.2003.02788_6.x
pubmed: 12523329
Chhabra S, Mohammed S. Difficult airway alert card: a good deed comes around. Indian J Anaesth. 2021;65:775.
doi: 10.4103/ija.ija_771_21
pubmed: 34898711
pmcid: 8607856
Baker PA, Moore CL, Hopley L, Herzer KR. Mark. Dissemination of critical airway information. Anaesth Intensive Care. 2013;41:334–41.
doi: 10.1177/0310057X1304100310
pubmed: 23659395
pmcid: 3888506
Iseli TA, Iseli CE, Golden JB, Jones VL, Boudreaux AM, Boyce JR, et al. Outcomes of intubation in difficult airways due to head and neck pathology. Ear Nose &Throat J. 2012;91:E1–5.
doi: 10.1177/014556131209100313
Heinrich S, Birkholz T, Irouschek A, Ackermann A, Schmidt J. Incidences and predictors of difficult laryngoscopy in adult patients undergoing general anesthesia: a single-center analysis of 102,305 case. J Anesth. 2013;27:815–21.
doi: 10.1007/s00540-013-1650-4
pubmed: 23748552
Lundstrøm LH, Møller AM, Rosenstock C, Astrup G, Gätke MR, Wetterslev J, et al. A documented previous difficult tracheal intubation as a prognostic test for a subsequent difficult tracheal intubation in adults. Anaesthesia. 2009;64:1081–88.
doi: 10.1111/j.1365-2044.2009.06057.x
pubmed: 19735399
Crosby ET, Cooper RM, Douglas MJ, Doyle DJ, Hung OR, Labrecque P, et al. The unanticipated difficult airway with recommendations for management. Can J Anesth. 1998;45:757–76.
doi: 10.1007/BF03012147
pubmed: 9793666
American Society of Anesthesiologists Task Force on Management of the Difficult Airway. Practice guidelines for management of the difficult airway: an updated report by the American Society of Anesthesiologists Task Force on Management of the difficult Airway. Anesthesiology. 2003;98:1269–77.
doi: 10.1097/00000542-200305000-00032
Heidi M, Koenig MD. No more difficult Airway, again! Time for consistent standardized written patient notification of a difficult Airway. APSF Newsl. 2010;25:33–4.
Apfelbaum JL, Hagberg CA, Connis RT, Abdelmalak BB, Agarkar M, Dutton RP, et al. American Society of Anesthesiologists Practice Guidelines for Management of the difficult Airway. Anesthesiology. 2022;136:31–81.
doi: 10.1097/ALN.0000000000004002
pubmed: 34762729
Tian M, Deng X, Zhu YS, Zuo M, Li ST, Wu XM. Expert Consensus on difficult Airway Management. J Clin Anesthesiology. 2009;25:200–3.
Yu BW, Wu XM, Zuo M, Deng X, Gao X, Tian M. Guidelines for difficult Airway Management. J Clin Anesthesiology. 2013;29:93–8.
Xia M, Ma W, Zuo M, Deng X, Xue F, Battaglini D, et al. Expert consensus on difficult airway assessment. Hepatobiliary Surg Nutr. 2023;12:545–66.
doi: 10.21037/hbsn-23-46
pubmed: 37600997
pmcid: 10432292
Pandit JJ, Marshall SD. The 2015 Difficult Airway Society guidelines: what about the anticipated difficult airway? A reply. Anaesthesia. 2016;71:468–69.
doi: 10.1111/anae.13444
pubmed: 26994535
Kaniyil S, Pavithran P, Rajesh MC, Arun Krishna AK, Venugopal V, Samuel SJ. All India Difficult Airway Association guidelines in pratice-A survey. Indian J Anaesth. 2021;65:471–78.
doi: 10.4103/ija.IJA_1584_20
pubmed: 34248191
pmcid: 8252996