National survey to assess the content and availability of difficult-airway carts in critical-care units in the United States.
We have surveyed the availability of equipment, content of difficult-airway carts (DAC), and training in the use of such equipment in intensive-care units (ICU). We devised a set of proposals regarding what constitutes the ideal DAC. We surveyed 300 ICU in the United States. The survey was conducted to inquire about the presence and content of a DAC. Only 70% of respondents had a DAC in their unit. 82% of units surveyed checked the contents of the cart daily. 80% of directors were aware of its location. 80% of units had an attached list of contents and 51% had an attached algorithm for management of a difficult airway. LMA was present in 80% followed by 35 and 30% for Combitube and pre-assembled needle cricothyroidotomy set. Under non-invasive airway devices, video laryngoscope with 48% was ahead of fibreoptic bronchoscope (38%) and lighted stylet (15%). 80% of units had a CO₂-detection device immediately available. Limited data are available on the impact of DAC in airway management in the ICU. It is strongly recommended that a DAC be present. What constitutes the ideal contents of a DAC is open to questions. We hope discussion will lead to consensus of what should or should not be included on the cart.
Porhomayon
Jahan
J
VA Western New York Healthcare System, Division of Critical Care and Pain Medicine, Department of Anesthesiology, State University of New York at Buffalo School of Medicine and Biomedical Sciences, Rm 203C, 3495 Bailey Ave, Buffalo, NY 14215, USA. jahanpor@buffalo.edu
El-Solh
Ali A
AA
Nader
Nader D
ND
D058109:Airway Management / Q000295:instrumentation* / Q000706:statistics & numerical data; D000758:Anesthesia; D003422:Critical Care / Q000458:organization & administration* / Q000706:statistics & numerical data; D004632:Emergency Medical Services; D019538:Health Care Surveys; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration* / Q000706:statistics & numerical data; D007442:Intubation, Intratracheal; D017214:Laryngeal Masks; D020704:Laryngoscopes; D007828:Laryngoscopy / Q000706:statistics & numerical data; D009873:Operating Rooms; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000628:therapy; D014481:United States