National survey on airway and difficult airway management in intensive care units

Objective To know organization, management and training in airway (AW) in Spanish Intensive Care Units (ICUs), with special interest in difficult airway (DAW). Design Descriptive cross-sectional study and χ2 subanalysis, conducted through a national survey from November 1st to December 15th, 2016. With the SEMICYUC's support, an online questionnaire of 27 items was sent to 179 ICUs. Setting ICUs of public, private centers, and consortia. Results In total, 101 units responded (56.4%), corresponding to 1827 beds and almost 95,000 incomes/year. The 85.1% are public hospitals, and 83.2% had residents. Of the responders, 22.8% do not use routinely AW assessment scales, being the most frequently used the Cormack–Mallampati association (35.6%). There is no intubation (IOT) protocol in 77.2%, or DAW protocol in 75.2%. An 82.2% have a DAW cart. The 48.5% have training in IOT, and in VAD 53.5%. Having a DAW expert is significantly associated with greater training in IOT (60% vs. 39.3%; p = 0.03), DAW (64.4% vs. 44.6%; p = 0.04), and more AW protocols (73.4% vs. 37.5%; p = 0.000). Having a specific guideline for DAW management in UCI is considered necessary in 99%. Conclusions There is room for improvement in AW management. It is necessary to identify an expert in DAW in each Unit, and the development of a specific guideline for DAW management in critical care.