Difficult Airway Equipment: A Survey of Standards across Metropolitan Perth

Abstract

The importance of appropriate equipment to manage the difficult airway has been highlighted by the publication of the Australian and New Zealand College of Anaesthetists (ANZCA) guidelines in 2012. We set out to audit compliance with these guidelines in all public and private sites providing general anaesthesia in metropolitan Perth. Public and private healthcare websites identified 39 sites of which 37 were studied. Institutional and ethics approval was obtained. A tick-box design audit tool, based on the ANZCA guidelines, was used to collect information regarding the dedicated difficult airway container (DDAC) at each site. As recommended in the guidelines, only equipment within the DDAC was considered. Further data about each site, including the number of theatre suites, satellite anaesthetic areas, use of capnography and categories of patients treated (adult, obstetric and paediatric) were collected. An adult DDAC was found at 92% of all sites, but none of the sites had all the essential equipment listed in the ANZCA guidelines. There was limited provision of adult difficult airway equipment within private sites compared to public, and less provision of paediatric difficult airway equipment across all sites treating paediatric patients in metropolitan Perth. Capnography was available in 76% of post anaesthesia care units and used regularly in 27%. Adherence to the ANZCA guidelines regarding the DDAC could be improved. Standardised equipment across a metropolitan region would be of value in the management of the difficult airway.

Human and equipment resources for difficult airway management, airway education programs, and capnometry use in Japanese emergency departments: a nationwide cross-sectional study

“…Our selection of items for inclusion in the questionnaire was based on previous work in which we investigated available DAM resources in the pre-hospital [ 21 ] and ICU [ 22 ] settings in Japan. We also referred to all relevant studies conducted in other countries that similarly assessed EDs [ 28 – 36 ], ICUs [ 37 – 41 ], ORs [ 42 – 45 ], and pre-hospital settings [ 46 – 48 ]. We then circulated drafts among the survey team members (an epidemiologist, anesthesiologists, and physicians specializing in emergency medicine) and finalized the questionnaire in April 2016.…”

The Difficult Airway Trolley: A Narrative Review and Practical Guide

“…Importantly, to reap the benefits of a well-designed DAT, it is crucial that those who use the DAT are knowledgeable about its organization and have acquired expertise on all included devices through clinical training and simulations. As a dedicated DAT is often present in sites providing general anesthesia, this is not consistently the case according to recent audits and surveys [6, 7]. Importantly, as most airway emergencies develop during the induction phase, incidents can occur throughout the anesthetic process, including extubation [8] and all the way to the postanesthesia care unit.…”

Availability and organization of difficult airway equipment in Swedish hospitals: A national survey of anaesthesiologists

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