National census of airway management techniques used for anaesthesia in the UK: first phase of the Fourth National Audit Project at the Royal College of Anaesthetists

摘要

Background. The first stage of the Royal College of Anaesthetists Fourth National AuditnProject (NAP4) (to determine the incidence of major complications of airwaynmanagement in the UK) required a national census of airway management techniquesncurrently in use.nMethods. A network of local reporters (LRs) was established, with a link to each of the 309nNational Health Service hospitals believed to undertake surgery. LRs were requested tonreport the primary airway management technique used for all general anaestheticsnperformed in their hospital during a specified 2 week period. Individual unit’s data fornthe survey period were extrapolated using a multiplier of 25 to provide an estimatednannual usage.nResults. Data were received from all 309 hospitals. The number of general anaestheticsnreported in the 2 weeks was 114 904 giving an estimate of 2.9 million annually. Eightyninenper cent of returns were reported by the LR to be ‘accurate’ or ‘a close estimate’ (annerror of ,10%). The primary airway management device for general anaesthesia was ansupraglottic airway in 64 623 (56.2%), a tracheal tube in 44 114 (38.4%), and a facemasknin 6167 (5.3%).nConclusions. The second stage of NAP4 is designed to register and collect details of eachnmajor airway complication from the same hospitals over a 12 month period. Thenindividual case reports will produce the numerator to calculate the incidence of airwayncomplications associated with general anaesthesia in the UK. The results of the censusnpresented here will provide the denominator.