The safe management of a difficult airway is the most important single skill for an anesthesiologist. Every critically ill patient is managed by the priority of A – B – C, or Airway – Breathing – Circulation. Just as the initial most important factors in real estate are location, location, location, the three initial important factors in a critically ill patient are airway, airway, airway. I’ve written previously on the American Society of Anesthesiologists 2022 modifications to their Difficult Airway Algorithm, on the importance of expert airway management, and on advice for avoiding lost airway lawsuits, but I haven’t discussed the economic consequences of each difficult airway patient.
A 2021 publication, “Factors and Economic Outcomes Associated with Documented Difficult Intubation in the United States,” by Moucharite et al, studied the economic cost of a difficult intubation in hospitalized patients. Using data from the Premier Healthcare Database, the study looked at adult patients with inpatient surgical admissions during 2016, 2017, and 2018. Patients in the difficult intubation group had average inpatient costs $14,468 higher than patients without difficult intubations.
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