Airway management is of key importance to all critical care providers and their patients. Unanticipated difficulties during airway management can lead to severe complications or death. However, prediction of difficulties with upper airway access is challenging. Until now the accuracy to predict a “difficult airway” with the current methods or classification systems is extremely low.
Recently in an editorial with the title “The Myth of the Difficult Airway – Airway Management Revisited” published in Anaesthesia Journal, a new approach to airway management and assessment was proposed by us.
The good news is that we are very good at predicting “easy or reassuring airways” and that we now have knowledge of many factors that can complicate airway management. This novel airway triage method is now available as a medical app to provide fast decision support prior to an airway management procedure. It can be used to make airway management safer.
The Airway Triage App includes two easy-to-use, validated and CE-registered checklists. These are the PHASE and HELPET checklists. These checklists include many factors including patient history, context, human factors and vital parameters. The airway of every patient is triaged by the medical professional as basic or advanced before the airway management procedure is started. The checklists can be used for patients older than 12 years of age.
A basic airway can be managed with basic airway management techniques by a trained person and in the unlikely event of problems, airway rescue is most probably possible. Patients with advanced airways may require techniques that are not often used and these patients should be managed by a specialist or team that has special skills and access to special airway devices. The number of complexity factors can be scored and these determine the risk of complications and the need for assistance.
With a new educational method, called “Circles Of Life Approach” (COLA), a structured approach and decision support is given to find out if the medical team needs help for the procedure and is “fit to fly with this airway”.