Difficult airway alert card: A good deed comes around.

Sir,

We read with great interest the article 'All India Difficult Airway Association guidelines in practice—A survey' by Kaniyil et al.[1] We congratulate the authors for the survey with a good response rate. Having indigenous airway management guidelines by All India Difficult Airway Association (AIDAA) was an important milestone.[2]

We routinely issue difficult airway alert cards, one copy of which is with the patient while another one is attached in medical records. The patient is sensitised regarding the importance of the alert card and asked to present it in future healthcare visits.

Lema-Florez et al.[3] conducted a systematic review of seven eligible studies regarding the use of wristbands to identify adult patients with known or predicted difficult airway. They concluded that 'The identification of difficult airway with wristbands at an appropriate time is a strategy that is low cost but has a high impact on morbidity'. The Difficult Airway Society also recommends airway alert form.[4]

In India, difficult airway alert cards seem to be the only feasible mechanism to convey vital information pertaining to airway. The information on the alert cards is invaluable for both unanticipated and anticipated difficult airways, where the future caregiver will not only anticipate the difficult airway but will also know how the airway was managed at the previous instance and will prepare accordingly.

As the famous saying goes 'A good deed comes around', issuing difficult airway alert card is a good deed which will, in the long run, reduce much of the airway-related morbidity/mortality.

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Conflicts of interest

There are no conflicts of interest.