Difficulties with airway management (AM) during induction and maintenance of general anesthesia and emergence from anesthesia may result in injuries (7, 10) with severe morbidity and mortality (14). Most of these adverse events are preventable, provided that equipment and assistance are available, the operator is skilled with different devices and techniques of AM, and a strategy for difficult airway (DA) management is followed (11).
Expert working groups have developed guidelines and recommendations for the management of the DA. The American Society of Anesthesiologists guideline, first published in 1993 as landmark publication (1), already advocated the immediate availability of a dedicated and well-equipped DA cart or an equivalent unit with the necessary equipment for all anesthetizing locations. The guidelines and recommendations for DA management formulated by other working groups (3, 4, 6, 9, 15) again emphasized the immediate provision of backup devices for difficult face-mask ventilation and conventional tracheal intubation.
The results of a survey questionnare in regard to equipment availability for AM, including all anesthesia departments in Austria (16), were considered by our working group to formulate these recommendations. We studied published guidelines and recommendations for the management of the DA; furthermore, we reviewed the current literature with emphasis on preparatory provisions and evaluated backup devices applied for DA management. Based on these reviews and available evidence, we generated these recomendations, primarily intended for adult patients, in order to assist the Austrian anesthesia community in formulating departmental directives. The nationwide provision of the immediate availability of a dedicated and well-equipped DA cart for all anesthetizing locations may improve patient care and prevent adverse outcomes associated with DA management.
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