Preliminary Survey on Airway Management in China

  Objective  To perform a preliminary survey on airway management in China.

  Methods  The postal questionnaires were sent to anesthesiologists in 78 hospitals of 27 provinces/municipalities/autonomous regions. The questionnaire contained four parts which included the general information of respondents, the knowledge and usage of various airway tools, the practical patterns to different clinical airway scenarios, and the administrative management of the anesthesiology department. Chi-square analysis was performed for categorical variable (teaching hospital or non-teaching hospital).

  Results  The response rate was 60.7%. Direct laryngoscope using Macintosh blade with standard handle, oral airway, and malleable stylet were the most familiar airway tools for all the respondents. Anesthesiologists in teaching hospitals had better knowledge and more frequent usage of Glidescope, seeing stylet, intubating laryngeal mask airway, and fiberoptical bronchoscope than those in non-teaching hospitals (P < 0.01). There were large variations between teaching and non-teaching hospitals in the knowledge and usage for other airway tools including emergency tools. Nearly half of respondents (46.9%) preferred to choose awake fiberopitcal intubation as their first choices for definite difficult intubation patients. When encountering unexpected difficult intubation, 79.2% of anesthesiologists would attempt alternative tools to intubate only if they could maintain the airway. For patients who were unable to be intubated or ventilated, 47.6% of the responders preferred to improve ventilation using larngeal mask airway as first choice while 52.4% preferred to establish an emergency airway via cricothyrotomy. For suspected difficult intubation, most respondents (92.6%) would attempt to paralyze patient and intubate with direct laryngoscopy. Teaching hospitals were better than nonteaching hospitals in terms of establishing simple airway management algorithm, subspecialty development, and staff training (P < 0.01).

  Conclusions  Although the knowledge and usage of airway tools differ among anesthesiologists in China, most of them well follow the airway management algorithm in different airway scenarios. However, the administrative management of the anesthesiology department requires further improvement.