Airway alerts: how UK anaesthetists organise, document and communicate difficult airway managment
Bibliographic record
Abstract
A questionnaire on documentation and communication of airway problems during anaesthesia was sent to 271 anaesthetic department College Tutors in the UK. Their responses were compared with three published recommendations. There was a 71.9% response rate. 70.8% of respondents met the recommendations of the American Society of Anesthesiologists (ASA) Task Force on the management of the difficult airway [1]. The recommendations of the Canadian Airway Focus Group [2] and those in the textbook ‘Difficulties in Tracheal Intubation’ [3] are more stringent than the ASA guidelines and were met by only 2.1% and 1.5% of respondents, respectively. Only 21% of departments have guidelines for communication and dissemination of information regarding a difficult airway. There is universal acceptance that documentation on the anaesthetic chart is essential. However, further communication of this information is less widely practiced. Worryingly, only 40% of respondents would give written information to the patient and only 26% write to the patient's general practitioner. Benumof [4] suggested that ‘the patient's responsible doctor must guarantee communication of this difficult airway experience to future care takers so that the near death experience does not become a future death.’ The majority of departments in the UK are failing to communicate this important information. We have produced an ‘Airway Alert’ scheme. It is a paper document printed in quadruplicate. Copies are intended for the patient, their general practitioner, the case record and Anaesthetic Department. Use of this scheme will allow concise and quick documentation and communication of an episode of difficult airway management.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.012 | 0.071 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.006 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.010 | 0.007 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".