Global Airway Management of the Unstable Cervical Spine Survey

dc.contributor.advisorHofmeyr, Ross
dc.contributor.advisorLlewellyn, Richard
dc.contributor.authorStegmann, George Frederik
dc.date.accessioned2022-03-17T09:11:23Z
dc.date.available2022-03-17T09:11:23Z
dc.date.issued2021
dc.date.updated2022-03-16T09:09:41Z
dc.description.abstractBackground Rapid growth in optical and video devices for indirect visualisation of the airway has expanded the options for emergency and elective endotracheal intubation in patients with unstable fractures of the cervical spine. Aiming to ascertain whether video laryngoscopy (VL) has replaced awake flexible intubation (AFI) as the preferred technique for airway management, we conducted a global survey to evaluate current clinical practice. Methods After ethics approval, we created a questionnaire featuring one emergency and one urgent elective hypothetical patient with unstable injuries of the cervical spine. Target sample sizes per country were estimated using data from the World Federation of Societies of Anaesthesiologists' (WFSA) Global Anaesthesia Workforce Survey. Respondents were asked about their training, experience, airway skills, current clinical setting, and availability of airway equipment, as well as their preferred airway strategy in each case. The questionnaire was actively distributed for one year through the WFSA member societies and via social networks to physician anaesthesia providers (PAPs). Global and regional trends were assessed using descriptive statistics. Results Of a total of 1904 responses, 1153 (101 countries) were included in the final analysis. In the emergency case, 46.9% (95% confidence interval [CI]: 44.0–49.8%) of participants preferred VL and 39.8% (95% CI: 38.0-42.6%) chose AFI. In the urgent elective case, 51.3% (95% CI: 48.3-54.3%) selected VL as their preferred method, while 37.3% (95% CI: 34.4-40.2%) indicated AFI. Significant regional variations in preference were found. Conclusion The results suggest that practice in airway management of unstable cervical spine fractures is changing, and currently tends to favour VL over AFI. There is a statistically significant preference for VL in elective cases, traditionally considered to be a stronghold of AFI.
dc.identifier.apacitationStegmann, G. F. (2021). <i>Global Airway Management of the Unstable Cervical Spine Survey</i>. (). ,Faculty of Health Sciences ,Department of Anaesthesia and Perioperative Medicine. Retrieved from http://hdl.handle.net/11427/36161en_ZA
dc.identifier.chicagocitationStegmann, George Frederik. <i>"Global Airway Management of the Unstable Cervical Spine Survey."</i> ., ,Faculty of Health Sciences ,Department of Anaesthesia and Perioperative Medicine, 2021. http://hdl.handle.net/11427/36161en_ZA
dc.identifier.citationStegmann, G.F. 2021. Global Airway Management of the Unstable Cervical Spine Survey. . ,Faculty of Health Sciences ,Department of Anaesthesia and Perioperative Medicine. http://hdl.handle.net/11427/36161en_ZA
dc.identifier.ris TY - Master Thesis AU - Stegmann, George Frederik AB - Background Rapid growth in optical and video devices for indirect visualisation of the airway has expanded the options for emergency and elective endotracheal intubation in patients with unstable fractures of the cervical spine. Aiming to ascertain whether video laryngoscopy (VL) has replaced awake flexible intubation (AFI) as the preferred technique for airway management, we conducted a global survey to evaluate current clinical practice. Methods After ethics approval, we created a questionnaire featuring one emergency and one urgent elective hypothetical patient with unstable injuries of the cervical spine. Target sample sizes per country were estimated using data from the World Federation of Societies of Anaesthesiologists' (WFSA) Global Anaesthesia Workforce Survey. Respondents were asked about their training, experience, airway skills, current clinical setting, and availability of airway equipment, as well as their preferred airway strategy in each case. The questionnaire was actively distributed for one year through the WFSA member societies and via social networks to physician anaesthesia providers (PAPs). Global and regional trends were assessed using descriptive statistics. Results Of a total of 1904 responses, 1153 (101 countries) were included in the final analysis. In the emergency case, 46.9% (95% confidence interval [CI]: 44.0–49.8%) of participants preferred VL and 39.8% (95% CI: 38.0-42.6%) chose AFI. In the urgent elective case, 51.3% (95% CI: 48.3-54.3%) selected VL as their preferred method, while 37.3% (95% CI: 34.4-40.2%) indicated AFI. Significant regional variations in preference were found. Conclusion The results suggest that practice in airway management of unstable cervical spine fractures is changing, and currently tends to favour VL over AFI. There is a statistically significant preference for VL in elective cases, traditionally considered to be a stronghold of AFI. DA - 2021_ DB - OpenUCT DP - University of Cape Town KW - Anaesthesia KW - Perioperative Medicine LK - https://open.uct.ac.za PY - 2021 T1 - Global Airway Management of the Unstable Cervical Spine Survey TI - Global Airway Management of the Unstable Cervical Spine Survey UR - http://hdl.handle.net/11427/36161 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/36161
dc.identifier.vancouvercitationStegmann GF. Global Airway Management of the Unstable Cervical Spine Survey. []. ,Faculty of Health Sciences ,Department of Anaesthesia and Perioperative Medicine, 2021 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/36161en_ZA
dc.language.rfc3066eng
dc.publisher.departmentDepartment of Anaesthesia and Perioperative Medicine
dc.publisher.facultyFaculty of Health Sciences
dc.subjectAnaesthesia
dc.subjectPerioperative Medicine
dc.titleGlobal Airway Management of the Unstable Cervical Spine Survey
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationlevelMMed
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