Assessment of difficult Airway management protocols used in selected Libyan hospitals and identify Major complications (Survey)

Kaothar S Abuokra; Afaf  J.  Hamza; Sumia  R Emhmed; Arwa M Al farnouk; Malak  A Abooadn; Mariam M Al taloua

doi:10.54361/ljmr.16209

Authors

Kaothar S. Abuokra ,Faculty of Medical Technology, University of Zawia, Libya Author
Afaf J. Hamza ,Faculty of Medical Technology, University of Zawia, Libya Author
Sumia R Emhmed ,Faculty of Medical Technology, University of Zawia, Libya Author
Arwa M Al farnouk Faculty of Medical Technology, University of Zawia, Libya Author
Malak A Abooadn Faculty of Medical Technology, University of Zawia, Libya Author
Mariam M Al taloua Faculty of Medical Technology, University of Zawia, Libya Author

DOI:

https://doi.org/10.54361/ljmr.16209

Keywords:

Difficult airway, Techniques, management, Anaesthesia, Intubation, complications

Abstract

Airway management is a medical process that used to control the ventilation in clear airway problems. Most of times obstructed airway occurs due to loss of consciousness which is common in patients with serious illness or patients who require resuscitation, which may lead to cardiorespiratory arrest. In which a rapid assessment of a patient’s airway, ventilation and lung oxygenation is required to avoid hypoxia and its complications on the brain and other organs. Difficult airway management is being an alarming issue in anesthesia and in emergencies that the anesthesiologists faced with ventilation mask, tracheal incubation in some cases. The current study's goals are to evaluate and contrast the procedures and recommendations for difficult airway management that employed in selected Libyan hospitals. Using a questionnaire, the study was conducted in five hospitals in western Libya between December 2017 and June 2018. SPSS software and the F test used to analyze the collected data. The results of this study confirmed that there is no significant difference in techniques used in management patients with of difficult intubation among compared hospitals in the selected sample. To conclude, most of airway complications are unsuspected and can increase the mortality rate, particularly in the intensive care unit and emergency department, which must have well trained, prepared and educated staff in addition the most developed devices. These complications include; pulmonary aspiration, esophageal intubation, and failed airway management.

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References

McNarry, A. F., & Patel, A. (2017). The evolution of airway management - new concepts and conflicts with traditional practice. British journal of anaesthesia, 119(suppl_1), i154–i166. https://doi.org/10.1093/bja/aex385.

Butterworth IV, J. F., Mackey, D. C., & Wasnick, J. D. (2013). Morgan & Mikhail’s Clinical Anaesthesiology, fifth Edition. LANGE

Becker, D. E., Rosenberg, M. B., & Phero, J. C. (2014). Essentials of airway management, oxygenation, and ventilation: part 1: basic equipment and devices. Anesthesia progress, 61(2), 78–83. https://doi.org/10.2344/0003-3006-61.2.78.

Cook, T. M., & MacDougall-Davis, S. R. (2012). Complications and failure of airway management. British journal of anaesthesia, 109 Suppl 1, i68–i85. https://doi.org/10.1093/bja/aes393 .

Higgs, A., McGrath, B. A., Goddard, C., Rangasami, J., Suntharalingam, G., Gale, R., & Society, D. A. (2016). Guidelines for the management of tracheal intubation in critically ill adults. British journal of anaesthesia, 120(2), 323-352.

Gwinnutt, M., & Gwinnutt, C. L. (2016). Clinical anaesthesia. John Wiley & Sons.

Eley, V., Lloyd, B., Scott, J., & Greenland, K. (2008). Availability of difficult airway equipment to rural anaesthetists in Queensland, Australia. Rural and Remote Health, 8(4), 1-9.

Gupta, S., Sharma, K.R., & Jain, D. (2005). Airway assessment : Predictors of difficult airway. Indian Journal of Anaesthesia, 49, 257.

Soleimanpour, M., Rahmani, F., Morteza Bagi, H. R., Ala, A., Mahmoodpoor, A., Hassani, F., Mahdi Sharifi, S., Mehdizadeh Esfanjani, R., & Soleimanpour, H. (2018). Comparison of Three Techniques on Facility of Bag-Mask Ventilation: Thenar Eminence, E-O and E-C. Anesthesiology and pain medicine, 8(4), e74226. Available from: https://doi.org/10.5812/aapm.74226

Law, J. A., Broemling, N., Cooper, R. M., Drolet, P., Duggan, L. V., Griesdale, D. E., ... & Wong, D. T. (2013). The difficult airway with recommendations for management–part 1–difficult tracheal intubation encountered in an unconscious/induced patient. Canadian Journal of Anesthesia/Journal canadien d'anesthésie, 60(11), 1089-1118.

Hagberg, C. A., Gabel, J. C., & Connis, R. T. (2015). Difficult Airway Society 2015 guidelines for the management of unanticipated difficult intubation in adults: not just another algorithm. BJA: British Journal of Anaesthesia, 115(6), 812-814.

Lacquiere, D. A., Hodzovic, I., Woollard, A., Varvinskiy, A., Chishti, K., & Hughes, R. (2016). DAS 2015 guidelines for management of CICO. BJA: British Journal of Anaesthesia, 117(4), 532-533.

Macêdo, M. B., Guimarães, R. B., RIBEIRO, S., & SOUSA, K. (2016). Emergency cricothyrotomy: temporary measure or definitive airway? A systematic review. Revista do Colégio Brasileiro de Cirurgiões, 43, 493-499. https://doi.org/10.1590/0100-69912016006010

Law, J. A., Duggan, L. V., Asselin, M., Baker, P., Crosby, E., Downey, A., ... & Jones, P. M. (2021). Canadian Airway Focus Group updated consensus-based recommendations for management of the difficult airway: part 2. Planning and implementing safe management of the patient with an anticipated difficult airway. Canadian Journal of Anesthesia/Journal canadien d'anesthésie, 68(9), 1405-1436.