Airway Code Calls - Survey of Management

This is a survey of airway codes, which are emergency mobile phone requests for anaesthetic help to manage acute airway crises in the hospital (out of theatre, out of Surgical Intensive Care Unit, SICU).

The anaesthetists are doctors trained in advance airway management. Patients in the hospital may suffer airway crises e.g. airway obstruction or need for tracheal intubation (insertion of breathing tube) for various reasons. The on call SICU anaesthetists responds to the airway code by attending the patient in need and managing the patient at their own discretion.

Airway management will depend on the anaesthetist's knowledge, skills and experience. it will also depend on the available airway equipment.

We plan to evaluate airway codes for a 24 month period. Parameters include: type of incident; patient factors (including airway assessment); type of equipment used; anaesthetic drugs used; airway management chosen by the attending anaesthetist; and, airway complications.

Study Overview

• Status: Unknown
• Conditions: Intubation; Difficult

Detailed Description

Airway codes will be managed as standard care. These calls are taken and managed by anaesthetists on call on SICU. The audit form is filled in by the on call anaesthetist after the airway code has been managed. This is an audit looking at:

Primary outcome

•Evaluate the type of airway codes that the SICU anaesthetist is called for

Secondary outcomes:

• Patient factors (including airway assessment)
• Type of equipment used
• Type of anaesthetic drugs used
• Airway management chosen by the attending anaesthetist
• Airway complications.

• Study Type: Observational
• Enrollment (Anticipated): 300

Contacts and Locations

• Study Contact: Name: Jinbin Zhang, MBBS MMED; Phone Number: +6563577772; Email: jinbin_zhang@ttsh.com.sg

Study Locations

• Singapore
  • Singapore, Singapore, 169608
    • Recruiting
    • Singapore General Hospital
    • Contact: Zihui Tan, MMED; Phone Number: 63214220; Email: zihui.tan@mohh.com.sg
  • Singapore, Singapore, 308433
    • Recruiting
    • Tan Tock Seng Hospital
    • Contact: Jinbin Zhang, MMED; Phone Number: 62566011; Email: Jinbin_Zhang@ttsh.com.sg

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 1 year to 100 years (Child, Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

All 'airway code' requests for emergency anaesthetic airway support for adults outside operating theatre and Surgical Intensive Care Unit.

Description

Inclusion Criteria:

• adults outside operating theatre and Surgical Intensive Care Unit requiring emergency anaesthetic airway support

Exclusion Criteria:

• Nil

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Survey the type of airway codes that the SICU anaesthetist is called for	Cause of airway codes i.e. respiratory arrest or indication for formal airway management by anaesthetist	One hour post calling of airway code

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Survey of types of equipment needed for airway management	Type of equipment used include airway bag, bougie, videolaryngoscope	One hour post calling of airway code
Number of participants with predictors of difficult airway	Predictors of difficult airway include small mouth opening, short thyromental distance, prominent upper teeth, receding lower jaw, decreased neck movement, previous surgery, previous radiotherapy	One hour post calling of airway code

Collaborators and Investigators

• Sponsor: Singapore General Hospital
• Collaborators: Tan Tock Seng Hospital
• Investigators: Principal Investigator: Patrick Wong, MBBS FRCA, Singapore General Hospital

Publications and helpful links

General Publications

• Martin LD, Mhyre JM, Shanks AM, Tremper KK, Kheterpal S. 3,423 emergency tracheal intubations at a university hospital: airway outcomes and complications. Anesthesiology. 2011 Jan;114(1):42-8. doi: 10.1097/ALN.0b013e318201c415.
• Bowles TM, Freshwater-Turner DA, Janssen DJ, Peden CJ; RTIC Severn Group. Out-of-theatre tracheal intubation: prospective multicentre study of clinical practice and adverse events. Br J Anaesth. 2011 Nov;107(5):687-92. doi: 10.1093/bja/aer251. Epub 2011 Aug 8.

Study record dates

Study Major Dates

• Study Start: November 1, 2016
• Primary Completion (Anticipated): November 1, 2018
• Study Completion (Anticipated): November 1, 2018

Study Registration Dates

• First Submitted: January 24, 2017
• First Submitted That Met QC Criteria: January 26, 2017
• First Posted (Estimate): January 30, 2017

Study Record Updates

• Last Update Posted (Estimate): January 30, 2017
• Last Update Submitted That Met QC Criteria: January 26, 2017
• Last Verified: January 1, 2017

More Information

Terms related to this study

• Other Study ID Numbers: 1607 Airway Code

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO