Skip to main content Accessibility help
×
Hostname: page-component-7c8c6479df-24hb2 Total loading time: 0 Render date: 2024-03-19T02:52:49.577Z Has data issue: false hasContentIssue false

Chapter 3 - The Epidemiology of Airway Management Complications

from Section 1 - Airway Management: Background and Techniques

Published online by Cambridge University Press:  03 October 2020

Tim Cook
Affiliation:
Royal United Hospital, Bath, UK
Michael Seltz Kristensen
Affiliation:
Rigshospitalet, Copenhagen University Hospital, Denmark
Get access

Summary

Despite the training and skills of airway managers, airway management complications still occur and may cause patient harm or death. The causes are multifactorial and may include patient, environment and clinician factors. Airway complications likely contribute to a significant proportion of deaths due to anaesthesia and are certainly more common outside the operating theatre and especially in the critical care unit. Reported incidences of failure and harm during airway management vary depending on the population studied and definitions used. Numbers may be of less value than understanding themes that help us improve care and reduce harm. The chapter emphasises that conventional research (e.g. device evaluation studies and randomised controlled trials) may be of little use in identifying low frequency events and complications because of their restricted inclusion and exclusion criteria, the use of devices only by experts and in conventional settings and because of their focus on efficacy rather than safety. The chapter highlights the important and growing role of registries and databases. Several are described in detail including the 4th National Audit Project and the Dutch ‘mini-NAP’. The value and limitations of litigation databases are explored. Specific complications of note are described at the end of the chapter.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Further Reading

Cook, TM. (2018). Strategies for prevention of airway complications – a narrative review. Anaesthesia, 73, 93111.CrossRefGoogle ScholarPubMed
Cook, TM, Scott, S, Mihai, R. (2010). Litigation related to airway and respiratory complications of anaesthesia: an analysis of claims against the NHS in England 1995–2007. Anaesthesia, 65, 556563.CrossRefGoogle ScholarPubMed
Domino, KB, Posner, KL, Caplan, RA, Cheney, FW. (1999). Airway injury during anesthesia: a closed claims analysis. Anesthesiology, 91, 17031711.Google Scholar
Duggan, LV, Ballantyne Scott, B, Law, JA, et al. (2016). Transtracheal jet ventilation in the ‘can’t intubate can’t oxygenate’ emergency: a systematic review. British Journal of Anaesthesia, 117, i28i38.CrossRefGoogle ScholarPubMed
Cook, TM, Woodall, N, Frerk, C. (Eds.) (2011). Fourth National Audit Project of the Royal College of Anaesthetists and Difficult Airway Society. Major Complications of Airway Management in the United Kingdom. Report and Findings. London: Royal College of Anaesthetists. ISBN 978-1-9000936-03-3. Available at: https://www.nationalauditprojects.org.uk/NAP4_home.Google Scholar
Huitink, JM, Lie, PP, Heideman, I, et al. (2017). A prospective, cohort evaluation of major and minor airway management complications during routine anaesthetic care at an academic medical centre. Anaesthesia, 72, 4248.CrossRefGoogle ScholarPubMed
Jaber, S, Amraoui, J, Lefrant, JY, et al. (2006). Clinical practice and risk factors for immediate complications of endotracheal intubation in the intensive care unit: a prospective, multiple-center study. Crit Care Med, 34, 23552361.CrossRefGoogle ScholarPubMed
Mort, TC. (2004). Emergency tracheal intubation: complications associated with repeated laryngoscopic attempts. Anesthesia & Analgesia, 99, 607–13.Google ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×