Recent trends in tracheal intubation: a retrospective analysis of 97904 cases

We conducted a review of routine anaesthetic audit data collected between April 1995 and December 2001 at Northampton General Hospital. A total of 97 904 anaesthetics were given. The average monthly rate of tracheal intubation fell during the study period from approximately 450 per month to approximately 280 per month. This was largely at the expense of tracheal tubes used during normal working hours, which fell by 40% (from approximately 390 per month to approximately 230 per month). Use outside normal working hours did not change. Of those cases managed in normal working hours with a tracheal tube, the decline in use over time was most obvious in patients of ASA physical status 1-2, and whose surgery was classified as elective or scheduled. The proportion of cases classified as ASA 3-5 or whose surgery was urgent or emergency increased (from 15.5% to 22.3%, and from 7.5% to 15.5%, respectively.) There was considerable variation across surgical specialities, with the greatest decline in tracheal intubation in head and neck surgery. These changes in practice have implications for the teaching of airway management skills.