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Availability of Advanced Airway Equipment on Labor and Delivery Units
Abstract Number: T2A-404
Abstract Type: Original Research
Obstetric patients have a higher incidence of failed intubation compared to non-pregnant patients. Failure to obtain an advanced airway in emergency situations can result in devastating consequences for both the mother and fetus. The Obstetric Anaesthetists’ Association and Difficult Airway Society (OAA/ DAS) guidelines for management of difficult and failed tracheal intubation in obstetrics recommend immediate availability of a video laryngoscope for all obstetric general anesthetics. We sought to identify the availability of advanced airway equipment in academic obstetric anesthesia units in the US. We hypothesized that 75% or more would have a video laryngoscope available.
A survey was developed by an expert panel. The survey domains included hospital characteristics and the availability of advanced airway equipment on the labor and delivery (L&D) unit. The electronic survey was emailed to 98 directors of obstetric anesthesia units in the US. The primary outcome was the proportion of units which have dedicated advanced airway equipment, specifically video laryngoscopes, for management of difficult or emergency airways. Univariate statistics were used to characterize survey responses.
The survey response rate was 59%. 100% of respondents had at least one video laryngoscope, but only 84% had a flexible fiberoptic scope available. All respondents had laryngeal mask airways readily available, whereas only 47% and 78% had percutaneous tracheostomy and cricothyrotomy kits available, respectively. The equipment available in responding units is shown in Table 1.
The majority of academic L&D units have immediate access to at least one piece of advanced airway equipment, specifically a video laryngoscope. Every L&D unit has the appropriate equipment for initial management of a difficult airway; however, several units do not stock equipment for possible surgical airways, i.e. tracheostomy and cricothyrotomy kits. Given the potential morbidity and mortality associated with difficult or failed intubation, it is imperative that all units evaluate their ability to access emergency airway equipment.