Virtual Disaster Medicine

Training Center (VDMTC)

Module 3

Complications of Managing the Airway

Introduction

Difficulty in managing the airway is the most important cause of major anesthesiarelated morbidity and mortality. In the closed claims analysis of the American Society of Anesthesiologists (ASA), 6% of all claims concerned airway injury.¹ Difficult intubation was a factor in only 39% of airway injury claims; 87% of the airway injuries were temporary, and 8% resulted in death. In 21% of these claims, the standard of care was not performed. The incidence of affected anatomical structures is shown in Table 1.  Female gender, elective surgery and outpatient procedures showed a higher proportion of injury, whereas there was no difference regarding ASA status or obesity.

Table 1.  Severity of injury and standard of care.  TMJ, temporomandibular joint.  Modified from Domino et al (1999, Anesthesiology 91: 1703-1711) with permission.