Failed Intubation in Obstetrics –How I Do It? A Survey
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2017, Vol 5, Issue 7
Abstract
Abstract:Anesthesia related deaths are the seventh leading cause of maternal mortality. Most of these are related to failed intubation. Decision making in case of failed tracheal intubation for category 1 caeserean section (CS) for fetal distress still remains a dilemma, as to whether to wake up the mother or proceed with surgery. The Obstetric Anaesthetists’ Association(OAA) and Difficult Airway Society(DAS) introduced for the first time guidelines for the proper management of difficult and failed tracheal intubation during obstetric general anaesthesia in November 2015. These guidelines take into account specific problems relating to pregnancy, and formulate a protocol for management of difficult and failed intubation in case it occurs. Reduction in experience in general anaesthesia for obstetrics among anaesthetists prompted us to conduct survey to create awareness regarding latest guidelines so that lives of both mother and baby are not endangered.With that idea in mind we conducted a survey to know about awareness and practical use of DAS guidelines in obstetrics among anaesthetists attending Haryana Chapter of Indian Society of Anaesthesiologists Conference 2016. Printed performa with a set of questions was given to the delegates and the result was analysed.Only 13% of the study group had heard about the DAS guidelines and 88% of them would proceed with surgery even though failed intubation occurred. Besides only 16% could perform cricothyrotomy.There is an urgent need to spread awareness about the latest DAS guidelines and one way of achieving it is by demonstration in conferences across the world. Formal training in cricothyrotomy (scalpel) is the need of the hour in the dreaded ‘can’t intubate, can’t oxygenate’ (CICO.) situation. It should be incorporated in MD/DNB/Diploma curriculum so that the anaesthetist does not have to perform the procedure for the first time during emergencies. Keywords:Failed intubation, obstetrics DAS, cricothyrotomy.
Authors and Affiliations
Suchitra Malhotra, Mohinder Kumar
Keywords
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