Utility of letters sent to patients after difficult airway management

Study objective To determine whether postoperative "difficult airway" letters, which inform a patient that he has a difficult airway, are an effective way to communicate with patients and future caregivers. Design Patient telephone survey. Setting Tertiary referral and postgraduate teaching hospital. Patients 113 (of a total of 142) patients who were mailed a postoperative "difficult airway" letter during the time period 2000-2002, and who agreed to participate in the survey. Interventions and measurements The patients who participated in the study were asked a series of questions regarding their difficult airway history, including whether or not their primary care provider was aware of their condition, whether or not the patient had obtained a MedicAlert® bracelet or necklace as recommended, whether or not they had undergone subsequent surgery, and if so had they conveyed their difficult airway history to their surgeon or anesthesiologist. Main results Of the 142 patients who were sent letters, 113 agreed to participate. Of those who did not, two patients who were contacted refused to participate. Twenty-three patients could not be contacted following several attempts, and four patients had died. Twenty-eight patients (20%) stated they could not remember receiving a letter. Forty-six (41%) stated that they had informed their primary care provider about their difficult airway. Twenty-two of 24 patients (92%) who had undergone subsequent surgery indicated they had informed their anesthesiologist about their airway. Twenty-six patients (23%) had registered with the MedicAlert Foundation. As a result of the survey, 44 patients requested more information about their airway and MedicAlert®. Conclusions The majority of patients who were sent a "difficult airway" letter did not obtain a MedicAlert® bracelet, although frequently recommended. However, most of the patients who subsequently had surgery informed their anesthesiologist or surgeon of their airway history. "Difficult airway" letters may have significant utility even if patients do not obtain identifying jewelry.