hig.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard-cite-them-right
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • sv-SE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • de-DE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
How anaesthesiologists understand difficult airway guidelines: an interview study
University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap.ORCID iD: 0000-0002-6960-270X
Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap.
Institutionen för hälsovetenskaper, Örebro universitet .ORCID iD: 0000-0002-2867-0490
Uppsala universitet, Institutionen för medicinska vetenskaper.ORCID iD: 0000-0002-6392-6092
Show others and affiliations
2017 (English)In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 122, no 4, p. 243-248Article in journal (Refereed) Published
Resource type
Text
Abstract [en]

Background: In the practice of anaesthesia, clinical guidelines that aim to improve the safety of airway procedures have been developed. The aim of this study was to explore how anaesthesiologists understand or conceive of difficult airway management algorithms.

Methods: A qualitative phenomenographic design was chosen to explore anaesthesiologists’ views on airway algorithms. Anaesthesiologists working in three hospitals were included. Individual face-to-face interviews were conducted.

Results: Four different ways of understanding were identified, describing airway algorithms as: (A) a law-like rule for how to act in difficult airway situations; (B) a cognitive aid, an action plan for difficult airway situations; (C) a basis for developing flexible, personal action plans for the difficult airway; and (D) the experts’ consensus, a set of scientifically based guidelines for handling the difficult airway.

Conclusions: The interviewed anaesthesiologists understood difficult airway management guidelines/algorithms very differently.

Place, publisher, year, edition, pages
2017. Vol. 122, no 4, p. 243-248
Keywords [en]
Airway guidelines, algorithms, qualitative study
National Category
Anesthesiology and Intensive Care
Identifiers
URN: urn:nbn:se:hig:diva-21452DOI: 10.1080/03009734.2017.1406020ISI: 000423294800006PubMedID: 29299973Scopus ID: 2-s2.0-85041236643OAI: oai:DiVA.org:hig-21452DiVA, id: diva2:924924
Projects
Patientsäkerhet och omvårdnad i samband med anestesi med fokus på luftvägen
Funder
Swedish Heart Lung FoundationAvailable from: 2016-03-30 Created: 2016-04-29 Last updated: 2018-03-13Bibliographically approved
In thesis
1. Airway management in anaesthesia care: professional and patient perspectives
Open this publication in new window or tab >>Airway management in anaesthesia care: professional and patient perspectives
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Careful airway management, including tracheal intubation, is important when performing anaesthesia in order to achieve safe tracheal intubation. Aim: To study airway management in anaesthesia care from both the professional and patient perspectives. Methods: 11 RNAs performed three airway tests in 87 patients, monitored in a study-specific questionnaire. The tests usefulness for predicting an easy intubation was analysed (Study I). 68 of 74 anaesthesia departments in Sweden answered a self-reported questionnaire about the presence of airway guidelines (Study II). 20 anaesthesiologists were interviewed; a phenomenographic analysis was performed to describe how anaesthesiologists' understand algorithms for management of the difficult airway (Study III). 13 patients were interviewed; content analysis was performed to describe patients' experiences of being awake fiberoptic intubated (Study IV). Results: The Mallampati classification is a good screening test for predicting easy intubation and intubation can be safely performed by RNAs (Study I). The presence of airway guidelines in Swedish anaesthesia departments is poorly implemented (Study II). Algorithms can be understood as law-like rules, a succinct plan to follow in difficult airway situations, an action plan kept in the back of one's mind while creating flexible and versatile personal algorithms, or as consensus guidelines based on expert opinion in order to be followed in clinical practice (Study III). One theme emerged describing experiences of being awake intubated; feelings of being in a vulnerable situation but cared for in safe hands, described in five categories: a need for tailored information, distress and fear of the intubation, acceptance and trust of the staff's competence, professional caring and support, and no hesitation about new awake intubation (Study IV). Conclusions: The Mallampati classification is a good screening test for predicting easy intubation, when the airway assessment is performed in a structured manner by RNAs. The presence of airway guidelines in Swedish anaesthesia departments was poorly implemented and should receive higher priority. Algorithms need to be simple and easy to follow and based on the best available scientific evidence. Tailored information about what to expect, ensuring eye contact, and giving breathing instructions during the procedure may reduce patients' feeling distress.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2016. p. 56
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1205
Keywords
Airway management, algorithm, awake intubation, professional and patient perspective
National Category
Nursing Anesthesiology and Intensive Care
Research subject
Medical Science
Identifiers
urn:nbn:se:hig:diva-21451 (URN)978-91-554-9534-3 (ISBN)
Public defence
2016-05-20, Brömssalen, Gävle sjukhus, Lasarettsvägen 1, 13:00 (Swedish)
Opponent
Supervisors
Projects
Patientsäkerhet och omvårdnad i samband med anestesi med fokus på luftvägen
Available from: 2016-04-29 Created: 2016-04-29 Last updated: 2018-03-13Bibliographically approved

Open Access in DiVA

No full text in DiVA

Other links

Publisher's full textPubMedScopus

Authority records BETA

Knudsen, KatiNilsson, UlricaHögman, Marieann

Search in DiVA

By author/editor
Knudsen, KatiNilsson, UlricaHögman, Marieann
By organisation
Caring science
In the same journal
Upsala Journal of Medical Sciences
Anesthesiology and Intensive Care

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 540 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard-cite-them-right
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • sv-SE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • de-DE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf