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Need for emergency airway surgery for hard-to-intubate patients reduced
Date:11/17/2009

ar needed the emergency procedure. In the past year, Berkow says, no patients at Johns Hopkins have needed unplanned emergency airway surgery.

The findings are published online and will be in the December issue of the journal Anesthesia & Analgesia.

The cart is but one part of Hopkins' difficult airway program. Doctors have been educated how to spot someone with a potentially life-threatening obstruction and how to use the items on the cart to properly deal with it. When it is difficult to put a breathing tube in place for a particular patient, that information goes into the patient's electronic health record so future providers will be aware of and prepared to deal with potential problems.

The decrease in the number of surgical airway procedures at Hopkins occurred despite an increase in patients reported to have a "difficult airway" as well as an overall increase in the number of patients receiving anesthesia per year, Berkow says. Airway-related deaths also declined after the initiation of the program, but the difference was not statistically significant because of the small numbers.

More patients are appearing with difficult airways, she says, as the population gets older, sicker and larger all signals that inserting a breathing tube could be tricky. Presently, only one to 10 percent of patients have difficult airways, Berkow says. A miniscule number of those will require surgical intervention an incision just below the Adam's apple or into the trachea to ensure air is getting into the lungs.

"We took disorganization and created an organized, standardized system, which we've continued to adapt and update as new technology comes out. We keep all of our staff updated on the system," Berkow says, "and we found it improves outcomes."


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Contact: Stephanie Desmon
sdesmon1@jhmi.edu
410-955-8665
Johns Hopkins Medical Institutions
Source:Eurekalert

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