Magnitude of Airway Problems at a University Teaching and Referral Hospital Recovery Room of Low Resource Setting-A Cross Sectional Study

Abstract

Background: Airway management is a basic life-saving intervention which is used when the patient’s breathing effort is compromised due to various reasons. Postsurgical patients are at risk of developing airway problems due to co-morbidities, intraoperative complications, surgery and anaesthetic drug effects. The severity of illness, analgesic drugs like narcotics and postoperative standard of monitoring may impact on breathing process of the patients. We aimed to assess the magnitude of airway problems at the recovery room. Methods and material: Cross sectional study conducted at a referral hospital recovery room, 2014. Standardized checklist used for data collection. All patients with airway problem who admitted at the recovery room during the study period were included in the study. Descriptive statistics and Chi-square were used. Results: One hundred seventy seven patients developed airway problems over five months duration. Of these, 47.5%, 32.2%, and 20.3% patients developed mild, moderate and severe airway problems respectively. The major airway problems were desaturation (62.7%), respiratory arrest (14.7%), aspiration (18.1%), bronchospasm (3.4%) and laryngospasm (1.1%) respectively. Factors associated with severity of airway problems were ASA status (P=0.031), type of trauma (P=0.026), intraoperative analgesia (P=0.020) and type of patient (P=0.049). The interventions made were ETTI or LMA (35%) patients, nasopharyngeal airway insertion (21.5%), oral airway (14.1%), oxygen supplementation (10.2%), surgical airway (9.6%), recovery position (7.3%) and emergency airway manoeuvre (2.3%) respectively. Anaesthetists involved in airway management in 30.5% of patients. Conclusion: The magnitude of airway problem was high. We recommend the availability of well trained staff for airway management and fulfilment of basic equipments and drugs for patient monitoring and resuscitation. High airway problems are an alarm for the need for well-equipped recovery room with well trained staff, patient monitoring and resuscitation materials.