Difficult Airway Trolleys for the Critical Care Unit

Abstract

Airway management is paramount to patient safety in critical care. Intensive Care Society (ICS) standards state that all critical care areas should have a designated difficult airway trolley (DAT) equivalent to that found in operating theatres. We conducted a national survey to determine compliance with this guideline. Adult intensive care units (ICUs) were questioned about the presence of a DAT, its contents and airway training for clinicians. Two hundred and sixty-two ICUs responded to the survey (90%), of which 130 (50%) had a designated DAT. In 38 (29%), a difficult airway management algorithm was available. Capnography was unavailable in 51 (40%) units with a DAT. Compliance with ICS standards and guidelines should be encouraged with respect to DATs. DATs should be available for immediate use within the ICU. Staff should be trained in the use of DAT equipment and be familiar with a difficult airway management algorithm.