“Airway management complications during anaesthesia, in intensive care units and in emergency departments in the UK”

SummaryIn 2011 the Royal College of Anaesthetists and the Difficult Airway Society published their joint report, the Fourth National Audit Project (NAP4). This project investigated airway management practises and the major complications of airway management during anaesthesia, in the intensive care unit (ICU) and emergency departments (ED) throughout the UK over a one year period. Reports of 184 major complications were received: 133 during anaesthesia, 36 from ICU and 15 in the ED. In total 38 deaths were attributed to airway management: 16 during anaesthesia, 18 from ICU and 4 from the ED. During the year-long investigation 2.9 million general anaesthetics were estimated to have been administered, giving a point estimate of death from an airway event during anaesthesia as one per 180,000 general anaesthetics and a major complication rate of one in 22,000. When compared to anaesthesia the risk of a major airway complication was 36 times higher in the ED and 56 times higher in ICU. Detailed analysis of the individual cases identified a number of themes and learning points leading to the publication of over 160 recommendations and important opportunities to improve patient care.