Implementation of a Difficult Airway Extubation Guideline

Abstract

Tracheal extubation is a high-risk intervention that should be managed strategically by anesthesia providers. The outcomes of a difficult airway extubation can be catastrophic, ranging from significant morbidity to mortality. The purpose of this project was to increase the awareness of anesthesia providers managing difficult airway extubation and assess the willingness to utilize the difficult airway extubation guidelines to guide care. The Difficult Airway Society and the American Society of Anesthesiologists have developed extubation guidelines to mitigate peri-operative complications that can arise during tracheal extubation. These guidelines have been developed as a resource for tracheal extubation and emergence. For this project, an educational presentation was used to increase provider awareness and utilization of difficult airways. Additionally, a cognitive aid of the difficult airway extubation guidelines was developed as a resource for anesthesia providers. A quantitative pre- and post-intervention design was used to evaluate this quality improvement project. When evaluating this quality improvement (QI) project, the data showed a statistical significance for an increase in awareness of risk factors that impact difficult airway management following the educational presentation. Data also supported increasing provider willingness to utilize the difficult airway extubation guidelines when comparing the pre- and post-survey assessment. This QI project was effective in increasing provider awareness and willingness to utilize the difficult airway extubation guidelines. This project created value by increasing awareness and willingness to utilize the difficult airway extubation guidelines thereby prioritizing the highest standard of care for airway extubation management.