Key result
Anesthesiologists report retrieving difficult airway information in only ~29% of cases despite expecting universal access.
Why the study?
There is no well-established difficult airway notification system in China to improve patient care, prompting an investigation into critical communication and current knowledge regarding difficult airway management.
Cross-Sectional (n=196)
No
Absolute Event Rate: 100% vs 28.9%
p-value: p=<0.0001
There is a significant gap in effective difficult airway information dissemination, highlighting the need for a standardized registry and notification system.
Identifies major retrieval gaps for airway data; leaves open whether registries improve access in practice.
Background Difficult airway is one of the greatest challenges faced by anesthesiologists and is a potential risk factor for increased fatality in patients. To date, there is no well-established and all-around difficult airway notification system in China, which has recently been recommended by existing guidelines to improve the care of patients with known difficult airways. This study aimed to investigate the status of critical information communication concerning difficult airway management and the current knowledge of the difficult airway notification system in our institute. Methods Vital information required to establish a difficult airway registry and notification system were collected through a literature review and expert suggestions. After approval by the Research Ethics Board, three online questionnaires were developed and sent to surgeons, anesthesiologists, and proxies of the patients. Knowledge of difficult airways and the status of difficult airway information dissemination among the three groups were investigated. The willingness of the participants to take part in the difficult airway registry and notification system was assessed. Results A significant difference was observed between what was expected and what was the reality to when the anesthesiologist retrieved the airway information of a patient with known airway difficulty. A significantly higher proportion of anesthesiologists would verbally disseminate airway information to the surgeons and other anesthesiologists, while a significantly higher proportion of anesthesiologists would disseminate airway information to the patients both verbally and in writing. Furthermore, a significantly higher proportion of anesthesiologists would communicate the detailed information to other anesthesiologists rather than to the patients or the surgeons. Most participants agreed with the necessity of setting up a difficult airway registry and notification system and were willing to take part in developing the system despite the significantly lower percentage in the patient group. Conclusions Difficult airway information is currently ineffective, which leads to a large gap between the expectation and reality of the anesthesiologist when caring for a patient with a difficult airway. Thus, a difficult airway registry and notification system that has a solid foundation for patients, surgeons, and anesthesiologists should be developed. Trial registration: The study was approved by the Research Ethic Board of Children’s Hospital of Fudan University and was registered at www.chictr.org.cn (registration number: ChiCTR2200063995).
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Shi et al. (2023) conducted a cross-sectional in Difficult airway (n=196). Difficult airway information dissemination survey was evaluated on Ability to obtain difficult airway information (Expected vs Actual among anesthesiologists) (p=<0.0001). Anesthesiologists reported a significant gap between their expectation to obtain difficult airway information (100%) and their actual ability to retrieve it in clinical practice (29%, p<0.0001).
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