Abstract
Multiple professional groups and societies worldwide have produced airway management guidelines. These are typically targeted at the process of tracheal intubation by a particular provider group in a restricted category of patients and reflect practice preferences in a particular geographical region. The existence of multiple distinct guidelines for some (but not other) closely related circumstances, increases complexity and may obscure the underlying principles that are common to all of them. This has the potential to increase cognitive load; promote the grouping of ideas in silos; impair teamwork; and ultimately compromise patient care. Development of a single set of airway management guidelines that can be applied across and beyond these domains may improve implementation; promote standardisation; and facilitate collaboration between airway practitioners from diverse backgrounds. A global multidisciplinary group of both airway operators and assistants was assembled. Over a 3-year period, a review of the existing airway guidelines and multiple reviews of the primary literature were combined with a structured process for determining expert consensus. Any discrepancies between these were analysed and reconciled. Where evidence in the literature was lacking, recommendations were made by expert consensus. Using the above process, a set of evidence-based airway management guidelines was developed in consultation with airway practitioners from a broad spectrum of disciplines and geographical locations. While consistent with the recommendations of the existing English language guidelines, these universal guidelines also incorporate the most recent concepts in airway management as well as statements on areas not widely addressed by the existing guidelines. The recommendations will be published in four parts that respectively address: airway evaluation; airway strategy; airway rescue and communication of airway outcomes. Together, these universal guidelines will provide a single, comprehensive approach to airway management that can be consistently applied by airway practitioners globally, independent of their clinical background or the circumstances in which airway management occurs.
| Original language | English |
|---|---|
| Pages (from-to) | 1671-1682 |
| Number of pages | 12 |
| Journal | Anaesthesia |
| Volume | 75 |
| Issue number | 12 |
| DOIs | |
| Publication status | Published - Dec 2020 |
Bibliographical note
Funding Information:Additional information on the project is available at https://www.UniversalAirway.org. The authors would like to thank Dr C. Noonan for his input into development of the standardised critical appraisal template (online Supporting Information, Appendix S4). NC is the creator of the ‘Vortex Approach’ but has no financial interest in this material, which is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. NC has undertaken unpaid consultancy work for Verathon Inc. NC’s partner is employed by Verathon Inc. and he has accompanied her to a corporate retreat funded by Verathon Inc. AH is Treasurer of the Difficult Airway Society. RG is past president of the European Airway Management Society. PAB is the owner of Airway Simulation Ltd which manufactures the ORSIM® bronchoscopy simulator. CR is an independent contractor for Teleflex Inc. and also assists in the development and teaching of procedural skills labs. JS is faculty on The Difficult Airway Course; Associate Editor of Walls Manual of Emergency Airway Management; Associate Editor, Airway Management in Emergencies, Author UpToDate Chapter: RSI for Adults Outside the Operating Room; Author UpToDate Chapter: Emergency Cricothyrotomy; Consultant to Verathon Inc. MS has received paid consultancy from Teleflex Medical, Verathon Medical and DEAS Italia, is a patent co-owner (no royalties) of DEAS Italia and has received lecture grants and travel reimbursements from MSD Italia, MSD USA. CAH has received research support from Ambu, Karl Storz Endoscopy and Vyaire Medical. She has been a speaker for Karl Storz Endoscopy and has received honoraria from UpToDate and Elsevier. No other external funding or competing interests declared.
Publisher Copyright:
© 2020 The Authors. Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of Anaesthetists.
ASJC Scopus Subject Areas
- Anesthesiology and Pain Medicine