Is the anesthesiologist actually prepared for loss of airway or respiratory function? A cross-sectional study conducted in a tertiary hospital

Abstract

Objective To identify compliance with the procedures for securing the airway of patients submitted to anesthesia, defined as highly recommended in the World Health Organization Surgical Safety Checklist. Methods A prospective, cross-sectional, observational study was conducted with 87 patients aged 18 to 60 years, classified as ASA grade 1 or 2 according to the American Society of Anesthesiologists’ Physical Status Classification. The study variables consisted of: whether the Mallampati test had been performed, whether equipment was readily available for orotracheal intubation, whether the correct placement of the endotracheal tube was verified, whether patient ventilation was monitored and whether fasting was confirmed. Prevalence ratios and their respective 95% confidence intervals were calculated as measures of relative risk. Statistical significance was defined at 5%. Results It was found that in 87.4% of patients, the airway was not evaluated using the Mallampati classification and in 51.7% of cases, preoperative fasting was not confirmed. In 29.9% of cases, the ready availability of equipment for orotracheal intubation was not verified. In all of the cases in which the availability of this equipment was not checked, the patient was submitted to regional anesthesia, with a statistically significant difference compared to the cases in which the patient was submitted to general anesthesia. Conclusion Measures considered essential for the safety of the patient during surgery are still being ignored.

Neck Circumference and Mallampati Classification

“…In a study completed by Vasconcelos et al (2014), 87 patients' records were reviewed to see if key components were completed prior to intubation. Data collected included whether a Mallampati classification was assigned, if fasting was assessed, if equipment was ready and if the endotracheal tube placement was verified by auscultation or capnography.…”

Observational Studies in Anesthesiology

“…It doesn't provide any causal relationship as it takes time for the exposure variable to affect the outcome variable. In a study conducted in a tertiary hospital to evaluate whether the anesthesiologists actually prepared for loss of airway or respiratory function and its association with regional/general anesthesia (5). Among the 87 procedures, 29.9% didn't have verification of the availability of material for orotracheal intubation.…”