Airway management (review of existing practice in the Russian Federation for 2020). Results of a multicenter study

Abstract

Introduction. The problem of “difficult airways” will always remain relevant, since critical gas exchange disorders lead to the death or deep neurological disability of patients. Objectives. To analyze the frequency of development of situations of “difficult airways”, the level of equipment of hospitals to ensure the airway management, to study the level of training of doctors and the algorithms used by them (comparative assessment of the situation in the dynamics of 2014-2019). Materials and methods. The survey was conducted from 01.03.2019 to 30.10.2020 by means of an online survey (https://ru.surveymonkey.com/r/HMTX2RR) and distribution of questionnaires (43 questions) by e-mail to anesthesiologists-resuscitators in medical organizations of various profiles. Results. 1260 responses were received. Only 47 % of respondents studied the issues of airway management during primary training in the specialty. In situations of difficult intubation or ventilation, almost 78 % of respondents use the FAR recommendations, almost 83 % of the respondents indicated that the FAR recommendations help them in practice. According to the survey data, most hospitals do not meet the legal requirements. Only 44 % of hospitals have a round-the-clock endoscopy service. In comparison with the previous surveys, the number of respondents who followed the recommended algorithms of actions in the situation of “no intubation - no oxygenation” during elective (70 %) and emergency (75 %) general anesthesia increased. However, only 60 % of specialists correctly identified the indications for performing emergency cricothyrotomy. Conclusions. Over the past 11 years, there has been a certain positive trend in relation to the growth of the level of education of specialists, changes in their approaches and a greater tendency to follow existing recommendations. The overwhelming majority of hospitals still do not meet the requirements of the legal framework.