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Awake Fiberoptic Intubation (AFOI) is the gold standard technique for difficult airway management. AFOI requires sedation, anxiolysis, and relief of discomfort without impairing ventilation, depressing cardiovascular function, a patent airway with blunting reflexes and spontaneous ventilation when the airway is difficult. Many agents like fentanyl, midazolam, ketamine, propofol and remifentanil have been used to facilitate AFOI. This quality improvement project composed of 13 randomized control trials (RCTs) reviewed different drug regimens for AFOI anticipated difficult airway, it also included studies examining elective awake fiberoptic intubation for scheduled surgery. The empirical evidence demonstrated that the occurrence of desaturation was less with dexmedetomidine or alfentanil when compared against fentanyl, remifentanil, and propofol. This quality improvement educational module seeks to assess anesthesia providers knowledge, on the efficacy of drugs, and drug regimens for AFOI. Anesthesia providers receiving the educational intervention will include Anesthesiologists and Certified Nurse Anesthetists (CRNA). The sample will include approximately 5-10 participants. The quality improvement project will involve three phases, pre-assessment testing, an online educational presentation, and a post-assessment exam. Pre-assessment and post-assessment testing will be used to measure the effects of the intervention. Statistical analysis will be applied to assess the knowledge of the educational intervention. It is projected that provider education will improve, providing the knowledge in dosages, side effects, complications, and pharmacological therapy needed to optimize sedation when performing an AFOI.
Roldan, Weslin Abisai and Miller, Ann, "A Pharmacological Evidence-Based Algorithm in the Management of Awake Fiberoptic Intubation" (2021). Nicole Wertheim College of Nursing Student Projects. 41.