All India Difficult Airway Association guidelines in practice-A survey.

Area of Science:

• Anesthesiology
• Airway Management
• Clinical Practice Guidelines

Background:

• The All India Difficult Airway Association (AIDAA) developed guidelines for difficult airway (DA) management tailored to the Indian context.
• An online survey was conducted to assess awareness and adherence to these AIDAA guidelines among practicing anesthesiologists.

Purpose of the Study:

• To determine the level of awareness regarding AIDAA difficult airway guidelines.
• To evaluate the adherence to these guidelines in clinical practice.
• To explore practice variations based on anesthesiologist experience and institution type.

Main Methods:

• An online, web-based questionnaire survey was distributed to anesthesiologists attending an airway workshop.
• The survey comprised 23 validated and piloted questions, utilizing a four-point Likert scale for practice patterns.

Main Results:

• A 66% response rate was achieved, with 81% awareness of AIDAA guidelines but varied adherence.
• Key adherence gaps identified include apnoeic nasal oxygen insufflation (19.59%), consistent capnography use (79.7%), and maintaining SpO2 ≥95% before repeat laryngoscopy (76.36%).
• While 50% were trained in cricothyrotomy, only 41% had readily accessible equipment. Capnography use was higher in private institutions.

Conclusions:

• High awareness of AIDAA difficult airway guidelines exists, yet practical adherence requires improvement.
• Specific areas needing enhanced implementation include departmental debriefing of DA events, patient alert cards, capnography use, and nasal oxygenation techniques.
• Addressing these gaps is crucial for optimizing difficult airway management and patient safety in India.