Calder Alyson, Hegarty Mary, Davies Kylie, von Ungern-Sternberg Britta S
Department of Anaesthesia and Pain Management, Princess Margaret Hospital for Children, Perth, WA, Australia.
Paediatr Anaesth. 2012 Dec;22(12):1150-4. doi: 10.1111/pan.12058.
The pediatric difficult airway can be unexpected, leading to significant morbidity and mortality. Standardized emergency airway equipment should be available on a regularly checked difficult airway trolley (DAT). We conducted a survey to investigate pediatric anesthetists' knowledge, experience, and confidence with the DAT.
Members of the Association of Paediatric Anaesthetists of Great Britain and Ireland (APAGBI), European Society for Paediatric Anaesthesiology (ESPA) and their national societies, Canadian Pediatric Anesthesia Society (CPAS), and Society for Paediatric Anaesthesia in New Zealand and Australia (SPANZA) were invited to complete a survey between January and April 2011.
Six hundred and ninety-three anesthetists replied to the questionnaire. Six hundred and thirty-three (92%) stated they have a DAT in their theater suite, with 587 (98%) knowing its location. Three hundred and eight-seven (56%) anesthetists received formal DAT training. The lowest training levels were observed in Australia and the UK; 42% and 59%, respectively. Those receiving training were more likely to be confident/very confident in knowing the DAT contents (r = -0.321, P = 0.01). Three hundred and fifty-five (59%) anesthetists had used the DAT in the last 6 months, 82 (14%) in the last 6-12 months, 91 (15%) >1 year ago, and 72 (12%) had never used it. Frequency of use correlated moderately with higher confidence levels (r = -0.398, P = 0.01). One hundred and eight-three (31%) reported having experienced problems with DAT equipment (missing 20%, faulty 4%, unfamiliarity 7%).
Training and recent use of the DAT increases anesthetists' confidence, but is not a universal practice. A significant number of anesthetists reported problems with the DAT, raising issues of equipment maintenance and quality control.
小儿困难气道可能难以预料，会导致严重的发病和死亡。标准化的急救气道设备应配备在定期检查的困难气道推车上（DAT）。我们开展了一项调查，以了解小儿麻醉医生对困难气道推车的知识、经验和信心。
邀请大不列颠及爱尔兰小儿麻醉医师协会（APAGBI）、欧洲小儿麻醉学会（ESPA）及其各国学会、加拿大小儿麻醉学会（CPAS）以及新西兰和澳大利亚小儿麻醉学会（SPANZA）的成员在2011年1月至4月期间完成一项调查。
693名麻醉医生回复了问卷。633名（92%）表示其手术室有一台困难气道推车，其中587名（98%）知道其位置。387名（56%）麻醉医生接受过困难气道推车的正规培训。澳大利亚和英国的培训水平最低，分别为42%和59%。接受培训的人更有可能对了解困难气道推车的内容有信心/非常有信心（r = -0.321，P = 0.01）。355名（59%）麻醉医生在过去6个月内使用过困难气道推车，82名（14%）在过去6至12个月内使用过，91名（15%）在1年多以前使用过，72名（12%）从未使用过。使用频率与更高的信心水平呈中度相关（r = -0.398，P = 0.01）。183名（31%）报告在困难气道推车设备方面遇到过问题（缺失20%、故障4%、不熟悉7%）。
困难气道推车的培训和近期使用可增强麻醉医生的信心，但并非普遍做法。大量麻醉医生报告了困难气道推车的问题，引发了设备维护和质量控制问题。
