| Popis: |
Background A database of anticipated and unanticipated difficult airways encountered in anaesthetic practice is maintained at Great Ormond Street Hospital (GOSH), containing 474 individual events recorded since inception of the database in February 2011. Relevant demographic, clinical and anatomical information regarding each patient is collected, together with number of attempts at tracheal intubation and information regarding the intubation strategy employed for each attempt. We have also recently enabled a ‘difficult airway’ bookmark on the GOSH electronic data management (EDM) records system to flag potential difficult airways and upload details of the event for future care episodes. Project We seek to summarise the main findings of the data collection to date, comparing the results at GOSH with published findings at other paediatric centres. Goldenhar syndrome was present in 59 (12.4%), Pierre Robin 40 (8.4%), Treacher Collins 27 (5.7%), cleft lip/palate 17 (3.6%), Mucopolysaccharidoses 13 (2.74%) and Crouzon 6 (1.3%) of events. 35 (7.4%) of difficult airways in the database were deemed unpredictable (stated unpredicted by the anaesthetist along with absence of documented predictors of difficulty). Conclusion We also describe the work currently being done to update the database in order to improve accuracy, reliability and ease of data entry. This will facilitate improved use of the data for clinical care, quality improvement, comparison with other centres and direct research into optimum strategies for prediction and management of the paediatric difficult airway. |
