National survey to assess the content and availability of difficult-airway carts in critical-care units in the United States

J Anesth. 2010 Oct;24(5):811-4. doi: 10.1007/s00540-010-0996-0. Epub 2010 Aug 7.

Abstract

We have surveyed the availability of equipment, content of difficult-airway carts (DAC), and training in the use of such equipment in intensive-care units (ICU). We devised a set of proposals regarding what constitutes the ideal DAC. We surveyed 300 ICU in the United States. The survey was conducted to inquire about the presence and content of a DAC. Only 70% of respondents had a DAC in their unit. 82% of units surveyed checked the contents of the cart daily. 80% of directors were aware of its location. 80% of units had an attached list of contents and 51% had an attached algorithm for management of a difficult airway. LMA was present in 80% followed by 35 and 30% for Combitube and pre-assembled needle cricothyroidotomy set. Under non-invasive airway devices, video laryngoscope with 48% was ahead of fibreoptic bronchoscope (38%) and lighted stylet (15%). 80% of units had a CO₂-detection device immediately available. Limited data are available on the impact of DAC in airway management in the ICU. It is strongly recommended that a DAC be present. What constitutes the ideal contents of a DAC is open to questions. We hope discussion will lead to consensus of what should or should not be included on the cart.

MeSH terms

  • Airway Management / instrumentation*
  • Airway Management / statistics & numerical data
  • Anesthesia
  • Critical Care / organization & administration*
  • Critical Care / statistics & numerical data
  • Emergency Medical Services
  • Health Care Surveys
  • Humans
  • Intensive Care Units / organization & administration*
  • Intensive Care Units / statistics & numerical data
  • Intubation, Intratracheal
  • Laryngeal Masks
  • Laryngoscopes
  • Laryngoscopy / statistics & numerical data
  • Operating Rooms
  • Respiration, Artificial
  • Respiratory Insufficiency / therapy
  • United States