Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-26T23:55:32.475Z Has data issue: false hasContentIssue false

Difficult airway equipment in departments of emergency medicine in Ireland: results of a national survey

Published online by Cambridge University Press:  23 December 2004

K. Walsh
Affiliation:
Cork University Hospital, Department of Anaesthesia, Wilton, Cork, Ireland
F. Cummins
Affiliation:
Cork University Hospital, Department of Emergency Medicine, Wilton, Cork, Ireland
Get access

Abstract

Summary

Background and objective: Adverse effects associated with difficult airway management can be catastrophic and include death, brain injury and myocardial injury. Closed-malpractice claims have shown prolonged and persistent attempts at endotracheal intubation to be the most common situation leading to disastrous respiratory events. To date, there has been no evaluation of the types of difficult airway equipment currently available in Irish departments of emergency medicine. The objective of this survey was to identify the difficult airway equipment available in Irish departments of emergency medicine.

Methods: Departments of emergency medicine in the Republic of Ireland with at least one dedicated Emergency Medicine consultant were surveyed via telephone.

Results: All of the departments contacted held at least one alternative device on site for both ventilation and intubation. The most common alternative ventilation device was the laryngeal mask airway (89%). The most common alternative intubating device was the surgical airway device (100%).

Conclusions: Irish departments of emergency medicine compare well with those in the UK and USA, when surveyed concerning difficult airway equipment. However, we believe that this situation could be further improved by training inexperienced healthcare providers in the use of the laryngeal mask airway and intubating laryngeal mask airway, by placing greater emphasis on the ready availability of capnography and by the increased use of portable difficult airway storage units.

Type
Original Article
Copyright
2004 European Society of Anaesthesiology

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Practice guidelines for management of the difficult airway. A report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway. Anesthesiology 1993; 78: 597602.
Caplan RA, Posner KL, Ward RJ, Cheney FW. Adverse respiratory events in anesthesia: a closed claims analysis. Anesthesiology 1990; 72: 828833.Google Scholar
Crosby ET, Cooper RM, Douglas MJ, et al. The unanticipated difficult airway with recommendations for management. Can J Anesth 1998; 45: 757776.Google Scholar
Tayal VS, Riggs RW, Marx JA, Tomaszewski CA, Schneider RE. Rapid-sequence induction at an emergency medicine residency: success rates and adverse effects during a two-year period. Acad Emerg Med 1999; 6: 3137.Google Scholar
Sakles JC, Laurin EG, Rantapaa AA, Panacek EA. Airway management in the emergency department: a one-year study of 610 tracheal intubations. Ann Emerg Med 1998; 31: 325332.Google Scholar
Morton T, Brady S, Clancy M. Difficult airway equipment in English emergency departments. Anaesthesia 2000; 55: 485488.Google Scholar
Levitan RM, Kush S, Hollander JE. Devices for difficult airway management in academic emergency departments: results of a national survey. Ann Emerg Med 1999; 33: 694698.Google Scholar
Benumof JL. Management of the difficult adult airway. Anesthesiology 1991; 75: 10871110.Google Scholar
Rose DK, Cohen MM. The airway: problems and predictions in 18,500 patients. Can J Anesth 1994; 41: 372383.Google Scholar
Davies PFR, Tighe SQM, Greenslade GL, Evans GH. Laryngeal mask airway and tracheal tube insertion by unskilled personnel. Lancet 1990; 336: 977979.Google Scholar
Martin PD, Cyna AM, Hunter WAH, Henry J, Ramayya GP. Training nursing staff in airway management for resuscitation. A clinical comparison of the facemask and laryngeal mask. Anaesthesia 1993; 48: 3337.Google Scholar
Yardy N, Hancox D, Strang T. A comparison of two airway aids for emergency use by unskilled personnel. The Combitube and laryngeal mask. Anaesthesia 1999; 54: 181183.Google Scholar
Dörges V, Wenzel V, Neubert E, Schmucker P. Emergency airway management by intensive care unit nurses with the intubating laryngeal mask airway and the laryngeal tube. Crit Care 2000; 4: 369376.Google Scholar
Baskett PJF, Parr MJA, Nolan JP. The intubating laryngeal mask. Results of a multicentre trial with experience of 500 cases. Anaesthesia 1998; 53: 11741179.Google Scholar
Langeron O, Semjen F, Bourgain JL, Marsac A, Cros AM. Comparison of the intubating laryngeal mask airway with fiberoptic intubation in anticipated difficult airway management. Anesthesiology 2001; 94: 968972.Google Scholar
McGuire GP, Wong DT. Airway management: contents of a difficult intubation cart. Can J Anesth 1999; 46: 190191.Google Scholar
Benumof JL. The American Society of Anesthesiologists' management of the difficult airway algorithm and explanation – analysis of the algorithm. In: Benumof JL, ed. Airway Management, Principles and Practice.St. Louis, USA: Mosby – Year Book, 1996: 143156.
de Latorre F, Nolan J, Robertson C, Chamberlain D, Baskett P, European Resuscitation Council. European Resuscitation Council Guidelines 2000 for Adult Advanced Life Support. A statement from the Advanced Life Support Working Group (1) and approved by the Executive Committee of the European Resuscitation Council. Resuscitation 2001; 48: 211221.Google Scholar
Florance R, Griffiths R, Cope A. Capnography and ‘major’ accident and emergency departments in East Anglia. J Accid Emerg Med 1999; 16: 159.Google Scholar