Display options
Cite
Payne E, Ragheb J, Jewell ES, et al. Are physician assistant and patient airway assessments reliable compared to anesthesiologist assessments in detecting difficult airways in general surgical patients?. Perioper Med (Lond). 2017;6:20doi: 10.1186/s13741-017-0077-0.
Payne, E., Ragheb, J., Jewell, E. S., Huang, B. P., Bailey, A. M., Fritsch, L. M., & Engoren, M. (2017). Are physician assistant and patient airway assessments reliable compared to anesthesiologist assessments in detecting difficult airways in general surgical patients?. Perioperative medicine (London, England), 620. https://doi.org/10.1186/s13741-017-0077-0
Payne, Erin, et al. "Are physician assistant and patient airway assessments reliable compared to anesthesiologist assessments in detecting difficult airways in general surgical patients?." Perioperative medicine (London, England) vol. 6 (2017): 20. doi: https://doi.org/10.1186/s13741-017-0077-0
Payne E, Ragheb J, Jewell ES, Huang BP, Bailey AM, Fritsch LM, Engoren M. Are physician assistant and patient airway assessments reliable compared to anesthesiologist assessments in detecting difficult airways in general surgical patients?. Perioper Med (Lond). 2017 Nov 22;6:20. doi: 10.1186/s13741-017-0077-0. eCollection 2017. PMID: 29201360; PMCID: PMC5700753.
Copy Download .nbib Format: NLM
Share it on

Perioper Med (Lond). 2017 Nov 22;6:20. doi: 10.1186/s13741-017-0077-0. eCollection 2017.

Are physician assistant and patient airway assessments reliable compared to anesthesiologist assessments in detecting difficult airways in general surgical patients?.

Perioperative medicine (London, England)

Erin Payne, Jacqueline Ragheb, Elizabeth S Jewell, Betsy P Huang, Angela M Bailey, Laura M Fritsch, Milo Engoren

Affiliations

  1. Department of Anesthesiology, University of Michigan, 4383 Cardiovascular Center, 1500 E. Medical Center Drive, Ann Arbor, MI 48109-5861 USA.

PMID: 29201360 PMCID: PMC5700753 DOI: 10.1186/s13741-017-0077-0

Abstract

BACKGROUND: Airway management remains one of the most important responsibilities of anesthesiologists. Prediction of difficult airway allows time for proper selection of equipment, technique, and personnel experienced in managing patients with difficult airway. Face to face preoperative anesthesia interviews are difficult to conduct as they necessitate patients traveling to the clinics, and, in practice, are usually conducted in the morning of the procedure by the anesthesiologist, when identification of predictors of difficult intubation may lead to schedule delays or case cancelations. We hypothesized that an airway assessment tool could be used by patients or physician assistants to accurately assess their airways.

METHODS: We administered an airway assessment tool, which had been constructed in consultation with a psychometrician and revised after non-medical layperson feedback, to 215 patients presenting to the preoperative clinic for evaluation. Separately, patients had the airway exam performed by a physician assistant and an anesthesiologist. Agreement was compared using kappa.

RESULTS: We found good agreement between observers only on "can you put three fingers in your mouth?" (three-way kappa = .733,

CONCLUSIONS: Neither the patients' self-assessments nor the physician assistants' assessments were adequate to substitute for the anesthesiologists' airway assessments.

Keywords: Airway assessment; Anesthesiologist; Instrument; Mallampati

References

  1. Anesthesiology. 2002 Apr;96(4):1004-17 - PubMed
  2. Phys Ther. 2005 Mar;85(3):257-68 - PubMed
  3. Anaesthesia. 2010 Jun;65(6):556-63 - PubMed
  4. Eff Clin Pract. 1999 Jan-Feb;2(1):1-10 - PubMed
  5. Anesth Analg. 2009 Sep;109(3):822-4 - PubMed
  6. J Anaesthesiol Clin Pharmacol. 2012 Jan;28(1):66-9 - PubMed
  7. Emerg Med J. 2012 Jul;29(7):570-5 - PubMed
  8. Acta Anaesthesiol Scand. 2005 Sep;49(8):1057-62 - PubMed
  9. Indian J Anaesth. 2009 Feb;53(1):35-9 - PubMed
  10. Br J Anaesth. 2011 May;106(5):632-42 - PubMed
  11. Eur J Anaesthesiol. 2009 Dec;26(12):1003-9 - PubMed
  12. J Dent Hyg. 2013 Jun;87(3):134-9 - PubMed
  13. Anesthesiology. 2003 May;98(5):1269-77 - PubMed
  14. South Med J. 2014 Dec;107(12):764-7 - PubMed

Publication Types