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BJA Advance Access originally published online on June 27, 2007
British Journal of Anaesthesia 2007 99(3):425-428; doi:10.1093/bja/aem163
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Airway management for tonsillectomy: a national survey of UK practice{dagger}

M. B. Clarke, P. Forster and T. M. Cook*

Department of Anaesthesia, Royal United Hospital, Combe Park, Bath BA1 3NG, UK

* Corresponding author. E-mail: timcook007{at}googlemail.com

Background: The emergence of variant Creutzfeldt–Jakob disease (vCJD) prompted guidelines from the Department of Health that stress the use of disposable and protective equipment. This survey explores current methods of airway management for tonsillectomy in the UK and ascertains anaesthetists’ current knowledge and opinions of the guidelines and of vCJD.

Methods: Three hundred and five questionnaires were sent to all Royal College tutors across the UK to explore the current practice and adherence to the guidelines.

Results: The tracheal tube was the most frequently used airway across all age groups: 87% for <3 yr old, 79% for 3–16 yr old, and 73% for adults. Of the respondents who intubated, 57% protected the laryngoscope blade with a disposable sheath or used a disposable blade, while others used a reusable laryngoscope blade without protection. Fourteen per cent protected the laryngoscope handle, as recommended. When a reusable classic or flexible laryngeal mask airway was used, 45% reused it after routine sterilization. Thirty-eight per cent of respondents were unaware that any recommendations existed, 55% disagreed with them, and 84% were not fully compliant with them. Compliance rates did not differ between the anaesthetists who agreed or disagreed with the recommendations. Overall full compliance was achieved by only 16% of respondents. The most common reason for non-compliance was the lack of protection of the laryngoscope handle.

Conclusions: The survey demonstrates widespread non-compliance with and lack of knowledge of, national guidelines.

Keywords: anaesthesia, audit; complications, infection; equipment, airway; equipment, laryngoscope; equipment, masks anaesthesia

{dagger} Declaration of interest. Tim Cook has been paid by Intavent Orthofix and the LMA company (manufacturers of reusable laryngeal mask airways and single-use reinforced LMA) for lecturing. Postage costs for this survey were paid for by Intavent Orthofix. Only the authors were involved in conceiving of this survey, designing it, performing it, analysing the data, writing the paper, and the decision to submit it for publication.


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E-letters:

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GUIDELINES : THE ROLE OF SPECIALTY SOCIETIES IN PHYSICIANS’ KNOWLEDGE
Pascal Vignally, et al.
British Journal of Anaesthesia, 19 Jul 2007 [Full text]
Airway management for tonsillectomy: a national survey of UK practice.
Alexandra J Roper, et al.
British Journal of Anaesthesia, 10 Sep 2007 [Full text]
Airway management for tonsillectomy: a national survey of UK practice
tim m cook
British Journal of Anaesthesia, 25 Sep 2007 [Full text]
Re: Airway management for tonsillectomy: a national survey of UK practice
Francis E Arnstein
British Journal of Anaesthesia, 27 Sep 2007 [Full text]
Reusable laryngoscopes and risk of prion transmission
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British Journal of Anaesthesia, 27 Sep 2007 [Full text]
Re: Airway management for tonsillectomy: a national survey of UK practice
Wendy K Laupu
British Journal of Anaesthesia, 5 Oct 2007 [Full text]
Airway management for tonsillectomy: a national survey of UK practice
AR Lewis, et al.
British Journal of Anaesthesia, 5 Oct 2007 [Full text]
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