Survey of current practice in difficult airway management in Latvia

Activity: Talk or presentation typesPoster presentation


Background: There have been steady improvements in airway management, particularly becoming important during COVID.

Aim: To assess how anaesthesiologists deal with airway assessment and difficult airway management currently in Latvia.

Materials and Methods: We created a cross-sectional 30-question digital survey, approved by Riga Stradins university Ethics commission, in 2021 November among 315 anaesthesiologists in Latvia. Survey included demographic data, airway assessment and experience Difficult airway (DA management). Responses were collected and analyzed, using Statistical Package of Social Sciences (SPSS) version 21.

Results: Response rate was 163 (52%) (trainees 37 (22.84%), specialists 125 (77.16%)), working in Latvia. We realized that 45.68% are employed between 160 to 240 hours per month. Most of them (55.6%) combines work in intensive care (IC). Solely in IC work 12.66% and in anaesthesiology 32.28%. Most of specialists 123 (80%) work in the university hospitals, which are well equipped. Difficult intubation once in a month were uncounted by 66 (59.46%) of specialists, once in a week by 28 (25.3%). With variable frequency 118 respondents marked that video-assisted intubation without stylet is most often used for DA management, 72,3% respectively. We found that 99 (84.62%) do not use ultrasound (median distance from skin to epiglottis, to pre-epiglottic area) for airway assessment, as majority do not feel educated well enough. Moreover, only 30% stated that ultrasound could improve DA prediction rate. Awake fibreoptic intubation at least once was performed only by 36 (34%) specialists, only 2 specialists would perform it regularly. Surprisingly, 89 (81.91%) anaesthesiologists need assistance from interventional pulmonologist to perform awake fibreoptic intubation which would be planned in situations when obvious signs of DA are present, like Mallampati IV and at least one another sign: head, neck mouth tumours or burns (62%), mouth opening < 3.5cm (50%).

Conclusion: Our survey showed, that in most of cases DA management is performed with video-assisted intubation. Most of specialists when DA looks inevitable perform awake fibreoptic intubation with assistance of pulmonologist. Ultrasound is a new method in airway assessment and is not used daily. Further training in ultrasound and techniques such as fibreoptic intubation are essential to integrate them more in daily practise.
Period7 Oct 2022
Event titleDifficult Airway Society (DAS) Annual Scientific Meeting 2022
Event typeMeeting
LocationNewcastle, United KingdomShow on map
Degree of RecognitionInternational