Airway alerts: how UK anaesthetists organise, document and communicate difficult airway managment

Abstract

A questionnaire on documentation and communication of airway problems during anaesthesia was sent to 271 anaesthetic department College Tutors in the UK. Their responses were compared with three published recommendations. There was a 71.9% response rate. 70.8% of respondents met the recommendations of the American Society of Anesthesiologists (ASA) Task Force on the management of the difficult airway [1]. The recommendations of the Canadian Airway Focus Group [2] and those in the textbook ‘Difficulties in Tracheal Intubation’ [3] are more stringent than the ASA guidelines and were met by only 2.1% and 1.5% of respondents, respectively. Only 21% of departments have guidelines for communication and dissemination of information regarding a difficult airway. There is universal acceptance that documentation on the anaesthetic chart is essential. However, further communication of this information is less widely practiced. Worryingly, only 40% of respondents would give written information to the patient and only 26% write to the patient's general practitioner. Benumof [4] suggested that ‘the patient's responsible doctor must guarantee communication of this difficult airway experience to future care takers so that the near death experience does not become a future death.’ The majority of departments in the UK are failing to communicate this important information. We have produced an ‘Airway Alert’ scheme. It is a paper document printed in quadruplicate. Copies are intended for the patient, their general practitioner, the case record and Anaesthetic Department. Use of this scheme will allow concise and quick documentation and communication of an episode of difficult airway management.