Unexpected Difficult Airway, Intubation;Difficult, Airway Management
Conditions
Keywords
airway management, anesthesia, intubation, difficult airway
Brief summary
The aim of our study is to observationally examine our unexpected difficult airway incidence and intervention times. In addition, it is aimed to discuss the clinical effect of a team specialized in airway intervention intervening in cases by call on the success of airway intervention. In this discussion, it is aimed to use the opinion-opposition method.
Detailed description
Initiation of Airway Code: The Role of the Airway Team in Unexpected Difficult Airways The incidence of difficult airway is approximately 1 in 1000 cases and poses a significant perioperative risk to patients. Various classifications, guidelines, and approaches have been developed to identify patients with difficult airways. However, even the most well-known classifications are not 100% successful in predicting difficult airways. Consequently, some unexpected difficult airway cases are encountered, and their management continues to be a subject of new research in the literature. In situations involving difficult airways, having the same team respond to every case may pose a potential obstacle to the distribution of experience and responsibilities among other clinical staff. However, it is undeniable that experienced anesthetists are more successful in airway management, and the importance of airway-related training cannot be overstated. Similar to the code blue protocol used during cardiac arrests, the intervention of a trained external team in crisis situations, utilizing familiar equipment and applying data from previous cases for quality improvement, can provide significant benefits in airway management akin to those seen in cardiac arrests. This approach could also potentially enhance patient safety in internal medicine and surgical wards, as well as in certain intensive care units, where familiarity with airway management is limited. This study aims to discuss the positive and negative impacts of the airway teams intervention in unexpected difficult airway situations within the operating room, using a pro-con debate method.
Interventions
PROCEDUREVideolaryngoscopy
Situations in which the practitioner performs endotracheal intubation using a videolaryngoscope during airway intervention will be included in this group.
PROCEDUREFOB
Situations in which the practitioner performs endotracheal intubation using a fiberoptic bronchoscope during airway intervention will be included in this group.
PROCEDUREFOB+Aintree
Situations in which the practitioner performs endotracheal intubation using a Fiberoptic intubation via LMA with aintree catheter during airway intervention will be included in this group.
PROCEDUREClassic intubation with laryngoscopy
Situations in which the practitioner performs endotracheal intubation using a macintosh laryngoscope during airway intervention will be included in this group.
PROCEDUREOthers
Cases in which intubation cannot be performed, those who are awakened from anesthesia, or those in whom a surgical method is used for airway access will be included in this group.
Sponsors
Kocaeli City Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
1. Patients who will be operated under general anesthesia at Kocaeli City Hospital or who require perioperative endotracheal intubation will be included in our study. 2. Operations performed within the study time period will be taken 3. Patients whose anesthesiologists call for help for difficult airway will be included in the study. 4. Patients between the ages of 18-65 will be included in the study.
Exclusion criteria
\- 1. Expected difficult airway patients (mallampati 3-4) and other patients with high difficult airway scores will not be included in the study. 2\. Patients with difficult airway conditions but who will be awakened by giving up endotracheal intubation will not be included in the study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Successful endotracheal intubation rate in difficult airway | During the intraoperative period of difficult intubation case | The primary outcome of our study is the rate( in percent) of complication-free and successful endotracheal intubation performed by specialists or the airway team in unexpected difficult airway cases. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The response time of the airway team to the case and the tools they used | During the intraoperative period of difficult intubation case | In this section, the interventions performed by the airway team will be compared with the control group. The duration( time in minutes) of the intervention and the different airway tools used will be compared numerically. |
| airway intervention equipment | During the intraoperative period of difficult intubation case | To determine the most commonly used assistive devices (type) in airway intervention and to compare their frequencies ( in percent) in two different defined groups. |
Countries
Turkey (Türkiye)
Outcome results
None listed