Premium
Current UK practice of pediatric supraglottic airway devices – a survey of members of the A ssociation of P aediatric A naesthetists of G reat B ritain and I reland
Author(s) -
Bradley Anthony E.D.,
White Michelle C.,
Engelhardt Thomas,
Bayley Guy,
Beringer Richard M.
Publication year - 2013
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1111/pan.12230
Subject(s) - medicine , audit , family medicine , emergency medicine , medical emergency , management , economics
Summary Objectives Over half of general anesthetics in the UK involve supraglottic airway devices ( SAD s). The N ational A udit P roject 4 undertaken by the R oyal C ollege of A naesthetists demonstrated that aspiration was the most frequent complication relating to SAD use. SAD s designed to reduce this risk (second‐generation devices) are increasingly recommended in both adults and children. As well as routine use, SAD s are recommended for use in cases of ‘difficult airway’. This survey assessed current usage of SAD s in routine practice and difficult airways. Sixteen questions, approved by the A ssociation of P aediatric A naesthetists of G reat B ritain and I reland ( APAGBI ) survey committee, were distributed to all its members. Results Two hundred and forty‐four members responded. Eighty‐eight percent preferentially use first‐generation rather than second‐generation devices. The most important design feature was the availability of a complete range of sizes (84%). Seventy‐seven percent felt that randomized controlled trials assessing SAD safety in children are needed. In cases of failed intubation, classically shaped SAD s are preferred (79%). Three percent of responders intubate via an SAD routinely. Eighteen percent have employed this technique in an emergency. Thirty‐six percent of responders have found an SAD to function poorly. Conclusion Pediatric anesthesiologists appear slow to embrace second‐generation SAD s. The role of SAD s in the management of difficult airways is widely accepted. Research currently has little influence over the choice of which SAD to use, which is more likely determined by personal choice and departmental preference. There is a risk that some SAD s are unsafe.