Initiation of Airway Code: the Role of the Airway Team in Unexpected Difficult Airways

Kocaeli City Hospital

Status: Completed

Conditions: Intubation;Difficult; Airway Management; Unexpected Difficult Airway

Treatments: Procedure: Others; Procedure: FOB+Aintree; Procedure: FOB; Procedure: Videolaryngoscopy; Procedure: Classic intubation with laryngoscopy

Study type: Observational

Funder types: Other

Identifiers

NCT06448377

2025-25

Details and patient eligibility

About

The aim of our study is to observationally examine our unexpected difficult airway incidence and intervention times. In addition, it is aimed to discuss the clinical effect of a team specialized in airway intervention intervening in cases by call on the success of airway intervention. In this discussion, it is aimed to use the opinion-opposition method.

Full description

Initiation of Airway Code: The Role of the Airway Team in Unexpected Difficult Airways

The incidence of difficult airway is approximately 1 in 1000 cases and poses a significant perioperative risk to patients. Various classifications, guidelines, and approaches have been developed to identify patients with difficult airways. However, even the most well-known classifications are not 100% successful in predicting difficult airways. Consequently, some unexpected difficult airway cases are encountered, and their management continues to be a subject of new research in the literature.

In situations involving difficult airways, having the same team respond to every case may pose a potential obstacle to the distribution of experience and responsibilities among other clinical staff. However, it is undeniable that experienced anesthetists are more successful in airway management, and the importance of airway-related training cannot be overstated. Similar to the code blue protocol used during cardiac arrests, the intervention of a trained external team in crisis situations, utilizing familiar equipment and applying data from previous cases for quality improvement, can provide significant benefits in airway management akin to those seen in cardiac arrests. This approach could also potentially enhance patient safety in internal medicine and surgical wards, as well as in certain intensive care units, where familiarity with airway management is limited.

This study aims to discuss the positive and negative impacts of the airway teams intervention in unexpected difficult airway situations within the operating room, using a pro-con debate method.

Enrollment: 48 patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Patients who will be operated under general anesthesia at Kocaeli City Hospital or who require perioperative endotracheal intubation will be included in our study.
2. Operations performed within the study time period will be taken
3. Patients whose anesthesiologists call for help for difficult airway will be included in the study.
4. Patients between the ages of 18-65 will be included in the study.

Exclusion criteria

• 1. Expected difficult airway patients (mallampati 3-4) and other patients with high difficult airway scores will not be included in the study.

2. Patients with difficult airway conditions but who will be awakened by giving up endotracheal intubation will not be included in the study.

Trial design

48 participants in 2 patient groups

Airway Team Group

Description:

In this group, the intervention time and methods used by the airway team will be evaluated in patients who have been called for airway assistance.

Treatment:

Procedure: Classic intubation with laryngoscopy

Procedure: Videolaryngoscopy

Procedure: FOB

Procedure: FOB+Aintree

Procedure: Others

Control Group

Description:

In this group, anesthesiologists' feedback on difficult airway cases will be received.

Treatment:

Procedure: Classic intubation with laryngoscopy

Procedure: Videolaryngoscopy

Procedure: FOB

Procedure: FOB+Aintree

Procedure: Others