The anesthesiologists in the Beijing-Tianjin-Hebei region of China expressed a below-average level of job satisfaction, and suffered a significant degree of burnout. Improvement in job satisfaction and burnout might create a positive work climate that could benefit both the quality of patient care and the profession of anesthesiology in China.
(Anesth Analg. 2019;128(3):584–586. Doi:10.1213/ANE.0000000000003886)
While video laryngoscopy (VL) has brought substantial changes to the practice of airway management, the way anesthesiologists define a “difficult intubation” has not been altered accordingly. The American Society of Anesthesiologists has defined a “difficult airway” as “the clinical situation in which a conventionally trained anesthesiologist experiences difficulty with facemask ventilation of the upper airway, difficulty with intubation, or both,” and also has set forth clear, separate definitions of difficult endotracheal intubation and difficult laryngoscopy. These latter 2 definitions can be subjective and interpreted inconsistently, however, and varied devices and contexts make these definitions even more ambiguous. A patient may not be labeled as a difficult intubation by one provider, but labeled difficult by another provider in a different setting. A study by Lewis and colleagues showed when VL was used, there were significantly fewer failed intubations compared with direct laryngoscopy (DL) alone. However, VL has not outdone the success rate of awake fiberoptic intubations in patients with perceived difficult airway. VL is available in >90% of operating rooms in British National Health Service hospitals according to a survey by Cook and Kelly, and some studies have recommended the use of VL become standard of care for both routine and difficult intubations.
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