CRNA Airway Assessment in Patients with Obesity: A Quality Improvement Project

Abstract

Over 40% of adults in the United States are categorized as obese. Although obesity alone is not an independent risk factor for difficult airway, CRNAs may have more difficulty with perioperative airway management due to changes in physiology and development of comorbidities. There are many different techniques that can be used to properly assess the airway in the preoperative period, but no single source succinctly incorporates this information for managing potential difficult airways in patients with obesity. The purpose of this quality improvement project was to assess CRNAs’ perception of adequacy of a quick reference guide (QRG) as a useful tool for their practice as it pertains to assessment of the airway of patients with obesity. CRNAs at an outpatient center were asked to complete a pre-implementation survey, watch an educational video, use the QRG for two weeks, and complete a post-implementation survey. Results revealed that almost all CRNAs were already using at least two preoperative assessment techniques when assessing the airway of patients with obesity, currently recommended by the literature. The overall perception of the QRG was mostly positive, as all respondents to the post-implementation survey found the QRG to be at least mostly useful. Limitations of this project include a small sample size and lack of full participation in the pre-and post-implementation surveys. Recommendations for future studies include a larger number of participants and a longer implementation period.