Effects of age on emergency airway management

Abstract

Background/Purpose: Age is considered a risk factor for a difficult airway (DA) and can serve as guidance towards a quick decision in the management of an emergency airway. However, the effect of age on a DA is seldom evaluated. This study investigated the effect of age on the difficulty of emergency airway management to anticipate DAs, which would allow physicians to provide alternative approaches beforehand, thereby increasing the quality of emergency airway management in elderly patients. Methods: A study form that recorded potential risk factors for a DA was designed. Research nurses and physicians who had performed tracheal intubation completed a case report form in the emergency department of a medical centre for over a year. Risk factors for a DA were identified using logistic regression. Results: We recorded 114 attempts during the study period. Difficult mask ventilation (60.9% vs 10.0%, P < 0.001), but not difficult intubation (29.7% vs 22.0%, P = 0.355), was more frequently observed among elderly people compared with nonelderly patients. Conclusion: Physicians should anticipate difficult mask ventilation in emergency airway management, especially in elderly people, and patients with sunken cheeks or a short and thick neck.