Airway equipment on the intensive care unit for management of the unanticipated difficult intubation
© BioMed Central Ltd. 2007
Published: 22 March 2007
This study was designed to assess the ability of ICUs to deal with the unanticipated difficult intubation. The ICU is a location in which the incidence of difficult intubation has been found to be significantly higher than in theatre (8–22.5% vs 1.5%).
We contacted all adult general ICUs in the South of England and invited the physician responsible for airway management to take part in a structured interview. The interview was designed to follow the Difficult Airway Society (DAS) guidelines. We designed six equipment-related questions that identified a unit as achieving the minimum levels of equipment necessary. These included availability of laryngoscopes, capnography, LMA/ILMA, and rescue techniques.
Difficult intubation is more likely on the ICU, yet only 20% of units keep sufficient equipment immediately available. The most serious omissions were the 29% of units without a rescue technique immediately available and the one-third of units not routinely employing capnography.