Airway management in intensive care units in Rhineland-Palatinate : Evolution over five years

Abstract

Securing the airway in severely ill patients is associated with ahigh rate of complications. So far, no information exists about the equipment readily available for airway management in German intensive care units (ICUs). It is also unknown if the range of material has improved over time. In the present trial the availability of equipment for airway management in ICUs in Rhineland-Palatinate was evaluated at two different times. Using astructured questionnaire, all ICUs in the state were contacted in the years 2010 and 2015. The availability of different types of equipment for airway management, as well as the presence of atraining program for airway management, was evaluated. For 2010 data from 64ICUs were evaluated and for 2015 data sets from 63ICUs were collected. In 2010 indirect laryngoscopes were available in eight ICUs; in 2015 these devices were directly accessible in 43units (p< 0.0001). Extraglottic devices were available in all but one ICU in 2010 and all ICUs in 2015. Equipment for emergency surgical airway procedures was available in nearly every ICU (n= 60). The availability of capnography increased significantly from 2010 (n= 12) to 2015 (n= 56; p< 0.0001). In 2010 and 2015, frequent training with afocus on airway management was performed in 23 and 32units, respectively (p> 0.05). Most ICUs in Rhineland-Palatinate have abroad range of equipment for airway management available, and the range has significantly improved over the time period evaluated. The availability of indirect laryngoscopes and capnometers improved significantly. However, it is remarkable that in some ICU's there is still alack of equipment for advanced airway management.