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Global Airway Management of the Unstable Cervical Spine Survey
Background Rapid growth in optical and video devices for indirect visualisation of the airway has expanded the options for emergency and elective endotracheal intubation in patients with unstable fractures of the cervical spine. Aiming to ascertain whether video laryngoscopy (VL) has replaced awake...
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| Format: | Thesis |
| Language: | English |
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Department of Anaesthesia and Perioperative Medicine
2022
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| _version_ | 1867613959924744192 |
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| access_status_str | Open Access |
| author | Stegmann, George Frederik |
| author2 | Hofmeyr, Ross |
| author_browse | Hofmeyr, Ross Stegmann, George Frederik |
| author_facet | Hofmeyr, Ross Stegmann, George Frederik |
| author_sort | Stegmann, George Frederik |
| collection | Thesis |
| description | Background Rapid growth in optical and video devices for indirect visualisation of the airway has expanded the options for emergency and elective endotracheal intubation in patients with unstable fractures of the cervical spine. Aiming to ascertain whether video laryngoscopy (VL) has replaced awake flexible intubation (AFI) as the preferred technique for airway management, we conducted a global survey to evaluate current clinical practice. Methods After ethics approval, we created a questionnaire featuring one emergency and one urgent elective hypothetical patient with unstable injuries of the cervical spine. Target sample sizes per country were estimated using data from the World Federation of Societies of Anaesthesiologists' (WFSA) Global Anaesthesia Workforce Survey. Respondents were asked about their training, experience, airway skills, current clinical setting, and availability of airway equipment, as well as their preferred airway strategy in each case. The questionnaire was actively distributed for one year through the WFSA member societies and via social networks to physician anaesthesia providers (PAPs). Global and regional trends were assessed using descriptive statistics. Results Of a total of 1904 responses, 1153 (101 countries) were included in the final analysis. In the emergency case, 46.9% (95% confidence interval [CI]: 44.0–49.8%) of participants preferred VL and 39.8% (95% CI: 38.0-42.6%) chose AFI. In the urgent elective case, 51.3% (95% CI: 48.3-54.3%) selected VL as their preferred method, while 37.3% (95% CI: 34.4-40.2%) indicated AFI. Significant regional variations in preference were found. Conclusion The results suggest that practice in airway management of unstable cervical spine fractures is changing, and currently tends to favour VL over AFI. There is a statistically significant preference for VL in elective cases, traditionally considered to be a stronghold of AFI. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/36161 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:44:26.542Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2022 |
| publishDateRange | 2022 |
| publishDateSort | 2022 |
| publisher | Department of Anaesthesia and Perioperative Medicine |
| publisherStr | Department of Anaesthesia and Perioperative Medicine |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/36161 Global Airway Management of the Unstable Cervical Spine Survey Stegmann, George Frederik Hofmeyr, Ross Llewellyn, Richard Anaesthesia Perioperative Medicine Background Rapid growth in optical and video devices for indirect visualisation of the airway has expanded the options for emergency and elective endotracheal intubation in patients with unstable fractures of the cervical spine. Aiming to ascertain whether video laryngoscopy (VL) has replaced awake flexible intubation (AFI) as the preferred technique for airway management, we conducted a global survey to evaluate current clinical practice. Methods After ethics approval, we created a questionnaire featuring one emergency and one urgent elective hypothetical patient with unstable injuries of the cervical spine. Target sample sizes per country were estimated using data from the World Federation of Societies of Anaesthesiologists' (WFSA) Global Anaesthesia Workforce Survey. Respondents were asked about their training, experience, airway skills, current clinical setting, and availability of airway equipment, as well as their preferred airway strategy in each case. The questionnaire was actively distributed for one year through the WFSA member societies and via social networks to physician anaesthesia providers (PAPs). Global and regional trends were assessed using descriptive statistics. Results Of a total of 1904 responses, 1153 (101 countries) were included in the final analysis. In the emergency case, 46.9% (95% confidence interval [CI]: 44.0–49.8%) of participants preferred VL and 39.8% (95% CI: 38.0-42.6%) chose AFI. In the urgent elective case, 51.3% (95% CI: 48.3-54.3%) selected VL as their preferred method, while 37.3% (95% CI: 34.4-40.2%) indicated AFI. Significant regional variations in preference were found. Conclusion The results suggest that practice in airway management of unstable cervical spine fractures is changing, and currently tends to favour VL over AFI. There is a statistically significant preference for VL in elective cases, traditionally considered to be a stronghold of AFI. 2022-03-17T09:11:23Z 2022-03-17T09:11:23Z 2021 2022-03-16T09:09:41Z Master Thesis Masters MMed http://hdl.handle.net/11427/36161 eng application/pdf Department of Anaesthesia and Perioperative Medicine Faculty of Health Sciences |
| spellingShingle | Anaesthesia Perioperative Medicine Stegmann, George Frederik Global Airway Management of the Unstable Cervical Spine Survey |
| thesis_degree_str | Master's |
| title | Global Airway Management of the Unstable Cervical Spine Survey |
| title_full | Global Airway Management of the Unstable Cervical Spine Survey |
| title_fullStr | Global Airway Management of the Unstable Cervical Spine Survey |
| title_full_unstemmed | Global Airway Management of the Unstable Cervical Spine Survey |
| title_short | Global Airway Management of the Unstable Cervical Spine Survey |
| title_sort | global airway management of the unstable cervical spine survey |
| topic | Anaesthesia Perioperative Medicine |
| url | http://hdl.handle.net/11427/36161 |
| work_keys_str_mv | AT stegmanngeorgefrederik globalairwaymanagementoftheunstablecervicalspinesurvey |