Knowledge and Practices in difficult airway management among anaesthesia providers in Uganda: A cross-sectional study

Abstract

Introduction: Difficult airway scenarios can occur in the operating theatre as an anticipated or unanticipated event. Knowledge on airway management coupled with preparation, planning, communication and teamwork are essential for successful management of the difficult airway. These primarily human factors can be optimized to avert the complications of difficult airway management such as hypoxia, brain damage and death. The objectives of this study were to assess the knowledge of anaesthesia providers on difficult airway management and to describe their practice patterns in management of difficult airways. Methodology: This was a cross-sectional study among anaesthesia providers working in Uganda. Non-probability sampling of all anaesthesia providers was done and data was collected using a self-administered questionnaire. 288 anaesthesia providers participated in the study and the data was analysed using Stata 16. Results: 81.6% of anaesthesia providers had adequate knowledge consistent with the Difficult Airway Society guidelines. Most of the basic airway equipment and accessories were found to be readily available and their reported use was also high. Almost 30% of participants said they do not always do airway assessment before spinal anaesthesia and up to 50% do not always do it for regional anaesthesia. Muscle relaxation and intubating stylet are the most commonly used airway aids while video laryngoscope and flexible fibreoptic laryngoscope are the least used. Conclusions: We found a high level of knowledge on difficult airway management although some stages of managing a hypothetical patient scenario did not correspond with the high knowledge. There is a gap in availability and use of some airway equipment and a need for regular formal refresher courses in difficult airway management.