Anaesthesiological airway management in Denmark: assessment, equipment and documentation.
BACKGROUND
Failed intubation remains one cause of anaesthesia-related morbidity and mortality. In a recent survey in Denmark, 20% of respondents reported preventable mishaps in airway management.


METHODS
Assessment of the airway, and its documentation, as well as the availability of various equipment to manage a difficult airway, and the existence of a failed intubation plan were surveyed by mailing a questionnaire to the clinical directors of all 69 anaesthesia departments in Denmark.


RESULTS
Fifty-six departments (81%) returned the questionnaire. Pre-operative airway evaluation is performed in 90% of the departments. The tests included the mouth-opening test (77%), Mallampati score (48%), lower jaw protrusion (34%), neck mobility (63%), the measurement of the thyromental (11%) and sternomental distance (4%). The result of the tests are documented by 38% of the departments in the anaesthetic chart (96%), in the record (54%), on a card given to the patient (23%), in a letter sent to the patient's general practitioner (2%) or in a database (13%). The patients are personally informed in 82% of the departments. Only 54% of the departments have a failed intubation plan readily available.


CONCLUSIONS
The preoperative assessment of the airways and its documentation is still unsatisfactory, as is communicating with the patient after a case of a difficult/impossible intubation. The adoption of internationally recognized recommendations might improve airway management and teaching to the best standard possible in the already well-equipped Danish anaesthetic departments.
Mellado
P F
PF
Department of Anaesthesia, The Abdominal Centre, Section 2043, Copenhagen University Hospital, Rigshospitalet, Denmark.
Thunedborg
L P
LP
Swiatek
F
F
Kristensen
M S
MS
D000465:Algorithms; D000758:Anesthesia; D000761:Anesthesia Department, Hospital; D003718:Denmark; D005336:Fiber Optic Technology; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation / Q000379:methods; D017214:Laryngeal Masks; D020704:Laryngoscopes; D008334:Mandible / Q000502:physiology; D008499:Medical Records; D009068:Movement; D009333:Neck / Q000033:anatomy & histology / Q000502:physiology; D020380:Needs Assessment; D010347:Patient Care Planning; D012119:Respiration