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- Title
Inclusion of the Acute Care Surgeon in the Difficult Airway Protocol: A Nine-Year Experience.
- Authors
LEE, SEONG K.; ROSENTHAL, ANDREW A.; DAVARE, DAFNEY L.; KIFFIN, CHAUNIQUA; SANCHEZ, RAFAEL; HURTADO, MICHAEL; CARRILLO, EDDY H.
- Abstract
An emergency surgical airway is a lifesaving intervention required in the event of airway loss or respiratory failure when conventional endotracheal intubation cannot be performed. The Acute Care Surgery/Trauma Service is a critical component in the angioedema/difficult airway protocol at our institution. We conducted a retrospective review (2007-2016) to analyze the role our service has in managing patients requiring an emergency surgical airway. Cases were analyzed for preexisting conditions, hospital location of procedure, techniques, complications, and mortality. Our protocol involves early coordination between anesthesia and the Acute Care Surgery/Trauma Service for patients with a potentially difficult airway. If anesthesia is unable to intubate the patient, a surgical airway is performed. Patients are preemptively taken to the operating room (OR) if stable for transport. There were 43 surgical airways performed during the study period. All patients had a failed attempt with oral endotracheal intubation. The most common factors associated with these patients were history of tracheostomy, angioedema, or difficult anatomy. Nineteen (44%) of the surgical airways were performed in the OR. Three deaths (7%) occurred from cardiac or respiratory arrest despite the emergency procedure. No immediate deaths occurred in the patients taken to the OR. Early coordination in patients with a difficult airway is another hospital resource that the acute care surgeon can provide to improve patient outcomes.
- Subjects
ACUTE medical care; SURGEONS; AIRWAY (Anatomy); RESPIRATORY insufficiency; ANGIONEUROTIC edema; ARTIFICIAL respiration; CRITICAL care medicine; EMERGENCY medical services; MEDICAL protocols; TRACHEA intubation; TRACHEOTOMY; RETROSPECTIVE studies
- Publication
American Surgeon, 2017, Vol 83, Issue 9, p943
- ISSN
0003-1348
- Publication type
journal article
- DOI
10.1177/000313481708300929