Difficult airway awareness of physicians with specialty training in medicine

Abstract

Aim: Today, many physicians with specialization training in medicine need to intervene in emergency situations in patients whose airway is predicted to be difficult. In the new time, many new equipment is used to intervene in difficult airways. Being aware of and using these technologies is difficult or frightening for most physicians. This study was conducted to determine the awareness of physicians who are less likely to encounter patients with difficult airways, who are outside the department of anesthesiology and reanimation. Material and Methods: This study was a survey study conducted by asking 15 questions about difficult airway management to 150 physicians who received specialization training in the internal and surgical departments of Pamukkale University Faculty of Medicine. Their approaches to the difficult airway and their awareness ofn this issue, as well as and their responses to the applications in emergency situations related to the patients who were predicted to have a difficult airway were evaluated. Results: If the main results are summarized; as a result, the majority of the participants (76%) had practical experience in using the airway. In difficult airway situations, the majority of the participants (71.3%) preferred to use the general airway method as the first choice. Regarding the first person to be asked for help, the majority of the participants (59.3%) stated that they would call the assistant of the anesthesia department. The situation of refraining from intubation is related to gender, and female participants experienced this situation more frequently than male participants (p=0.016). Among participants specializing in internal medicine, the use of the general airway method was significantly lower than the use of the Laryngeal Mask Airway (LMA) and was similar to the use of intubation. In contrast, those specializing in surgical medicine used the general airway method significantly more frequently than the LMA, while the use of intubation was similar (p=0.003). Those with knowledge of the Mallampati score preferred the LMA significantly more frequently, followed by the airway method and intubation. Being a woman female gender increases the risk of abstaining from intubation by 2.56 times, while not working as a general practitioner increases the risk by 2.22 times. Disccussion: Anticipating the difficulties that may occur in airway control is vital for safe ventilation. In our study, we evaluated the approaches to difficult airway and their awareness of this issue of physicians who received specialization training in medicine apart from the department of anesthesiology and reanimation. Our findings showed that most of the residents had insufficient knowledge and experience in difficult airway management. All findings emphasizes the importance of interdisciplinary training and presents residents' understanding of difficult airway management and shows that they need more training and they need to gain more experience in this regard. The results of our study show that residency students from many different clinical branches actually need an interdisciplinary education.