Department of Anaesthesiology, Medical Centre of the Johannes Gutenberg-University, Mainz, Germany.
Department of Anaesthesiology and Intensive Care, Brothers of Mercy Hospital, Trier, Germany.
Anaesthesiologie. 2022 Dec;71(Suppl 2):190-197. doi: 10.1007/s00101-021-01025-3. Epub 2021 Aug 28.
There is a worldwide consensus among experts that guidelines and algorithms on airway management contribute to improved patient safety in anesthesia. The present study aimed to determine the current practice of airway management of German anesthesiologists and assess the safety gap, defined as the difference between observed and recommended practice, amongst these practitioners.
To determine the effect of implementing the guidelines on airway management practice in Germany amongst anesthesiologists and identify potential safety gaps.
A survey was conducted in September 2019 by contacting all registered members of the German Society of Anaesthesiology and Intensive Care Medicine (DGAI) via email. The participants were asked about their personal and institutional background, adherence to recommendations of the current German S1 guidelines and availability of airway devices.
A total of 1862 DGAI members completed the questionnaire (response rate 17%). The main outcome was that anesthesiologists mostly adhered to the guidelines, yet certain recommendations, particularly pertaining to specifics of preoxygenation and training, showed a safety gap. More than 90% of participants had a video laryngoscope and half had performed more than 25 awake intubations using a flexible endoscope; however, only 81% had a video laryngoscope with a hyperangulated blade. An estimated 16% of all intubations were performed with a video laryngoscope, and 1 in 4 participants had performed awake intubation with it. Nearly all participants had cared for patients with suspected difficult airways. Half of the participants had already faced a "cannot intubate, cannot oxygenate" (CICO) situation and one in five had to perform an emergency front of neck access (eFONA) at least once. In this case, almost two thirds used puncture-based techniques and one third scalpel-based techniques.
Current practice of airway management showed overall adherence to the current German guidelines on airway management, yet certain areas need to be improved.
专家们在全球范围内达成共识，认为气道管理指南和算法有助于提高麻醉中的患者安全性。本研究旨在确定德国麻醉师的气道管理现状，并评估这些从业者之间观察到的实践与推荐实践之间的安全差距。
确定在德国麻醉师中实施气道管理指南对实践的影响，并确定潜在的安全差距。
2019 年 9 月，通过电子邮件联系德国麻醉学会和重症监护医学学会（DGAI）的所有注册会员进行了一项调查。要求参与者介绍其个人和机构背景、对当前德国 S1 指南建议的遵循情况以及气道设备的可用性。
共有 1862 名 DGAI 会员完成了问卷调查（应答率 17%）。主要结果是麻醉师大多遵循指南，但某些建议，特别是关于预充氧和培训的具体建议，存在安全差距。超过 90%的参与者有视频喉镜，超过一半的人使用柔性内镜进行了超过 25 次清醒插管；然而，只有 81%的人有一个带有超角度刀片的视频喉镜。估计所有插管中有 16%是使用视频喉镜进行的，每 4 名参与者中有 1 名使用视频喉镜进行清醒插管。几乎所有参与者都曾照顾过疑似困难气道的患者。半数参与者已经面临“无法插管，无法给氧”（CICO）的情况，五分之一的人至少进行过一次紧急前路颈部入路（eFONA）。在这种情况下，近三分之二的人使用基于穿刺的技术，三分之一的人使用基于手术刀的技术。
当前的气道管理实践总体上遵循了当前德国的气道管理指南，但某些方面仍需改进。
