A United Kingdom national obstetric intubation equipment survey

Abstract 

Background

Failed intubation is relatively common in the obstetric patient. Overall, there has been a decline in experience of general anaesthesia in obstetrics. The level of anaesthetic preparedness in the event of a difficult obstetric intubation is unknown.

Methods

With approval from the Obstetric Anaesthetists’ Association, a national postal survey of obstetric units in the United Kingdom was conducted. The survey addressed airway equipment availability and existence of difficult airway algorithms and formal difficult airway drills. The number of deliveries, general anaesthetic cases and failed intubations in each unit was also ascertained.

Results

One hundred and eighty-seven units completed the national obstetric intubation equipment survey questionnaire (78% response rate). All obstetric units possessed a laryngoscope with a normal handle and adult Macintosh blade, a bougie and a laryngeal mask airway. A 7.0 internal diameter endotracheal tube was most often used for securing the airway, and 90% of units stored all airway equipment on a designated difficult airway trolley. A fiberoptic bronchoscope was not readily available and on average it would take >10min to obtain. A failed intubation incidence of 1:309 was reported. Only one third of units promoted difficult airway training.

Conclusion

Essential airway equipment was readily available in the event of a difficult obstetric intubation, with the exception of a fiberoptic bronchoscope. Few units conduct difficult airway training.

Keywords: Obstetric airway equipment, Difficult airway training