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Initiation of Airway Code: the Role of the Airway Team in Unexpected Difficult Airways

Completed
Conditions
Airway Management
Unexpected Difficult Airway
Intubation;Difficult
Interventions
Procedure: Videolaryngoscopy
Procedure: FOB
Procedure: FOB+Aintree
Procedure: Classic intubation with laryngoscopy
Procedure: Others
Registration Number
NCT06448377
Lead Sponsor
Kocaeli City Hospital
Brief Summary

The aim of our study is to observationally examine our unexpected difficult airway incidence and intervention times. In addition, it is aimed to discuss the clinical effect of a team specialized in airway intervention intervening in cases by call on the success of airway intervention. In this discussion, it is aimed to use the opinion-opposition method.

Detailed Description

Initiation of Airway Code: The Role of the Airway Team in Unexpected Difficult Airways

The incidence of difficult airway is approximately 1 in 1000 cases and poses a significant perioperative risk to patients. Various classifications, guidelines, and approaches have been developed to identify patients with difficult airways. However, even the most well-known classifications are not 100% successful in predicting difficult airways. Consequently, some unexpected difficult airway cases are encountered, and their management continues to be a subject of new research in the literature.

In situations involving difficult airways, having the same team respond to every case may pose a potential obstacle to the distribution of experience and responsibilities among other clinical staff. However, it is undeniable that experienced anesthetists are more successful in airway management, and the importance of airway-related training cannot be overstated. Similar to the code blue protocol used during cardiac arrests, the intervention of a trained external team in crisis situations, utilizing familiar equipment and applying data from previous cases for quality improvement, can provide significant benefits in airway management akin to those seen in cardiac arrests. This approach could also potentially enhance patient safety in internal medicine and surgical wards, as well as in certain intensive care units, where familiarity with airway management is limited.

This study aims to discuss the positive and negative impacts of the airway teams intervention in unexpected difficult airway situations within the operating room, using a pro-con debate method.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
48
Inclusion Criteria
  1. Patients who will be operated under general anesthesia at Kocaeli City Hospital or who require perioperative endotracheal intubation will be included in our study.
  2. Operations performed within the study time period will be taken
  3. Patients whose anesthesiologists call for help for difficult airway will be included in the study.
  4. Patients between the ages of 18-65 will be included in the study.
Exclusion Criteria
    1. Expected difficult airway patients (mallampati 3-4) and other patients with high difficult airway scores will not be included in the study.
  1. Patients with difficult airway conditions but who will be awakened by giving up endotracheal intubation will not be included in the study.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Airway Team GroupVideolaryngoscopyIn this group, the intervention time and methods used by the airway team will be evaluated in patients who have been called for airway assistance.
Airway Team GroupFOB+AintreeIn this group, the intervention time and methods used by the airway team will be evaluated in patients who have been called for airway assistance.
Control GroupClassic intubation with laryngoscopyIn this group, anesthesiologists' feedback on difficult airway cases will be received.
Airway Team GroupFOBIn this group, the intervention time and methods used by the airway team will be evaluated in patients who have been called for airway assistance.
Airway Team GroupOthersIn this group, the intervention time and methods used by the airway team will be evaluated in patients who have been called for airway assistance.
Airway Team GroupClassic intubation with laryngoscopyIn this group, the intervention time and methods used by the airway team will be evaluated in patients who have been called for airway assistance.
Control GroupVideolaryngoscopyIn this group, anesthesiologists' feedback on difficult airway cases will be received.
Control GroupFOB+AintreeIn this group, anesthesiologists' feedback on difficult airway cases will be received.
Control GroupOthersIn this group, anesthesiologists' feedback on difficult airway cases will be received.
Control GroupFOBIn this group, anesthesiologists' feedback on difficult airway cases will be received.
Primary Outcome Measures
NameTimeMethod
Successful endotracheal intubation rate in difficult airwayDuring the intraoperative period of difficult intubation case

The primary outcome of our study is the rate( in percent) of complication-free and successful endotracheal intubation performed by specialists or the airway team in unexpected difficult airway cases.

Secondary Outcome Measures
NameTimeMethod
airway intervention equipmentDuring the intraoperative period of difficult intubation case

To determine the most commonly used assistive devices (type) in airway intervention and to compare their frequencies ( in percent) in two different defined groups.

The response time of the airway team to the case and the tools they usedDuring the intraoperative period of difficult intubation case

In this section, the interventions performed by the airway team will be compared with the control group. The duration( time in minutes) of the intervention and the different airway tools used will be compared numerically.

Trial Locations

Locations (1)

Kocaeli City Hospital

🇹🇷

Kocaeli, Izmıt, Turkey

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