Results

 

 

Response Rate. The questionnaire forms were completed and returned by 82 (66 percent) of the 124 clinical directors; 54 and 28 forms were returned after the first and second mailing, respectively.

 

Data Evaluation. For this survey report on airway management (AM) behavior at anesthesia departments in Austria, answers to questions regarding preparatory provisions, knowledge of published guidelines and recommendations, provision of formulated departmental strategies, provision of experienced assistance, and follow-up patient care were evaluated.

 

Preparatory Provisions. The consequences of DA information when general anesthesia was required were provision of adequate equipment, provision of adequate equipment and an additional experienced operator when available, and routine management in 24, 66, and 10 percent, respectively.

 

Knowledge of Guidelines and Recommendations. Knowledge of at least one of the guidelines and recommendations for the management of the DA published in English or German was confirmed in 72 percent. The guidelines and recommendations of the American Society of Anesthesiology task force [published in 1993 (1) and updated in 2003 (2)], the British group [published in 2004 (11)], the Canadian group [published in 1998 (5)], and the German group [published in 2004 (4)] were known in 32 and 60, 16, 10, and 18 percent, respectively.

 

Provision of Formulated Departmental Strategies. Formulated strategies for DA management in general were provided in 52 percent. Strategies for the management of the anticipated DA were formulated in 46 percent; awake tracheal intubation was considered in 62 percent. Strategies for the unanticipated failed conventional tracheal intubation and adequate face-mask ventilation (MV) situation and the unanticipated failed conventional tracheal intubation and impossible MV situation were formulated in 44 and 40 precent, respectively. Limitations of conventional tracheal intubation attempts to a maximum number of 4 or less were provided in 30 percent; the maximum number was limited to 2, 3, and 4 attempts at 5, 18, and 2 departments, respectively. Strategies for tracheal extubation of the DA were formulated in 22 percent.

 

Provision of Experienced Assistance. A formal group of staff anesthetists experienced in emergency airway management (AM) techniques or at least one experienced airway manager on call for assistance in DA situations was available in 28 percent.

 

Follow-up Patient Care. Patients with an experienced DA were routinely observed for complaints and potential complicatons associated with AM  and consultations and examinations were routinely initiated to identify the cause(s) of the nonapparent DA in 34 and 16 percent, respectively.                  

 

 

Discussion