Difficult Airway Letter



Difficult Airway Letter


Lynette J. Mark

Lorraine J. Foley

Vinciya Pandian





1 I have already documented in the patient’s anesthesia records details about the difficult airway. Why should I provide a Difficult Airway Letter to the patient?

Guidelines from the American Society of Anesthesiologists (ASA) regarding patients with difficult airways recommend examining previous anesthetic records, if available, during preoperative assessments, documenting the presence and nature of the difficult airway in patient medical records, informing the patient about the difficulty encountered, and evaluating and following the patient for potential adverse events related to difficult airway management. Difficult airway information provided verbally to patients or family members before or at discharge may not be retained. Additionally, details pertaining to difficult airway management would probably be beyond a layman’s understanding. Only 44.4% of hospitals use electronic medical record systems. Many institutions store nonelectronic patient medical records offsite, making retrieval of vital information challenging, both for in-house needs and for exchange between institutions.

Comprehensive Difficult Airway Letters are invaluable for individual hospital registries and interhospital communications. Communicating difficult airway information to the patient with a letter enables that patient to help future providers be better prepared for airway management.


2 What should be included in a “Dear Patient” Difficult Airway Letter?

Some practitioners tend to limit the Difficult Airway Letter to a generic one, advising their patient to inform future care providers that they have a “difficult airway.” Although providers appreciate this alert, more detailed information would be beneficial. We recommend that the following comprehensive information be included in the Difficult Airway Letter to the patient: 1) date and institution where difficult airway was identified; 2) provider contact information; 3) patient characteristics, such as anatomic features, body mass index, and significant comorbidities; 4) type of difficulty encountered (mask ventilation, ventilation with supraglottic apparatus, intubation, extubation); 5) unsuccessful and successful techniques with best laryngeal visualization; 6) implications for future care; and 7) recommendations for registration with an emergency notification service.

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Mar 5, 2021 | Posted by in GENERAL | Comments Off on Difficult Airway Letter
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