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Updated: Jun 20, 2026
04:46
A Novel Rescue Technique for Difficult Intubation and Difficult Ventilation
Published on: January 17, 2011
Need for emergency surgical airway reduced by a comprehensive difficult airway program
Lauren C Berkow1, Robert S Greenberg, Kristin H Kan
1Department of Anesthesiology/Critical Care Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe St., Meyer 8-134, Baltimore, MD 21287, USA. lberkow1@jhmi.edu
Anesthesia and Analgesia
|August 29, 2009
Summary
Implementing a difficult airway program significantly reduced emergency surgical airways. This program proved effective in managing challenging airways and improving patient safety over an 11-year period.
Area of Science:
- Anesthesiology
- Critical Care Medicine
- Emergency Medicine
Background:
- Inability to intubate and ventilate patients with respiratory failure leads to severe complications.
- A difficult airway is defined by the inability to ventilate or intubate using standard techniques.
- Effective management of difficult airways is crucial for patient outcomes.
Purpose of the Study:
- To evaluate if a comprehensive difficult airway program reduces the need for emergency surgical airways.
- To assess the long-term impact of a difficult airway management program.
Main Methods:
- Retrospective review of a departmental database.
- Comparison of annual emergency surgical airway rates before (1992-1995) and after (1996-2006) program implementation.
- Analysis included data on cricothyrotomy and tracheostomy procedures.
Main Results:
- Emergency surgical airways decreased from 6.5 per year to 2.2 per year (P < 0.0001).
- A total of 26 surgical airways were performed in the 4 years prior to the program.
- Only 24 surgical airways were performed in the 11 years following program initiation.
Conclusions:
- A comprehensive difficult airway program is associated with a sustained reduction in emergency surgical airway procedures.
- The program's effectiveness was observed over an 11-year period.
- The reduction was achieved despite an increase in reported difficult airways and overall patient volume.
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