Airway Assessment by Non-anaesthetists

Abstract

Patients who may require surgery, visit our hospitals daily. Various forms of anaesthesia are given for these surgeries, which include local, regional and general anaesthesia. General anaesthesia may involve the use of devices to maintain a secure and safe airway.
The improper management of the airway is still an important cause of morbidity and even mortality in anaesthetic practice. This paper seeks to give guidelines for the non-anaesthetist to be able to identify patients whose airway may be difficult to manage during
surgery, since the surgeons see the patients first, long before the anaesthetist does. These airway assessment guidelines have been given based on the various surgical specialties such as general surgery, maxillofacial and neurosurgery. Specific surgical
disorders which have a relatively high percentage of difficult airway have been discussed. They include goitre, mediastinal masses, abscesses and burns around the head and neck. Medical conditions such as diabetes mellitus with expected difficult airway have also been discussed. A simple algorithm has been added as an additional guide. The paper ends with recommendations which include the establishment of difficult airway database and the running of regular workshops for anaesthetists and non-anaesthetists as a means of maintaining skills in the management of the airway of the surgical patient and thus improve on their outcome.