Current state and influencing factors in airbag management among emergency department nurses: A multicenter study.

BACKGROUND: The emergency department (ED) plays a critical role in establishing artificial airways and implementing mechanical ventilation. Managing airbags in the ED presents a prime opportunity to mitigate the risk of ventilator-associated pneumonia. Nonetheless, existing research has largely overlooked the understanding, beliefs, and practical dimensions of airway airbag management among ED nurses, with a predominant focus on intensive care unit nurses. AIM: To investigate the current status of ED nurses' knowledge, beliefs, and practical behaviors in airway airbag management and their influencing factors. METHODS: A survey was conducted from July 10th to August 10th, 2023, using convenience sampling on 520 ED nurses from 15 tertiary hospitals and 5 sary hospitals in Shanghai. Pathway analysis was utilized to analyze the influencing factors. RESULTS: The scores for ED nurses' airway airbag management knowledge were 60.26 ± 23.00, belief was 88.65 ± 13.36, and behavior was 75.10 ± 19.84. The main influencing factors of airbag management knowledge included participation in specialized nurse or mechanical ventilation training, department, and work experience in the department. Influencing factors of airbag management belief comprised knowledge, department, and participation in specialized nurse or mechanical ventilation training. Primary influencing factors of airbag management behavior included knowledge, belief, department, participation in specialized nurse or mechanical ventilation training, and professional title. The belief in airbag management among ED nurses acted as a partial mediator between knowledge and behavior, with a total effect value of 0.513, and an indirect effect of 0.085, constituting 16.6% of the total effect. CONCLUSION: ED nurses exhibit a positive attitude toward airbag management with relatively standardized practices, yet there remains room for improvement in their knowledge levels. Nursing managers should implement interventions tailored to the characteristics of ED nurses' airbag management knowledge, beliefs, and practices to enhance their airbag management proficiency.

Is there a correlation between the changes in airway inflammation and the changes in respiratory mechanics after vaping in patients with asthma?

BACKGROUND: Electronic cigarettes (ECs) have been promoted as alternatives to traditional cigarettes. AIM: To investigate ECs' effects on respiratory system, especially in patients with respiratory diseases. METHODS: We randomly selected 25 smokers with stable moderate asthma and matched them with 25 healthy smokers. All were subjucted to pulmonary function tests (PFTs), impulse oscillometry (IOS), fraction exhaled Nitric Oxide (FeNO), exhaled breathe condensate (EBC) and biomarker measurements before and after vaping one nicotine-containing EC. RESULTS: The increase in FeNO 30 minutes after EC, reflecting airway inflammation, significantly correlated with increase of residual volume (RV), total lung capacity, respiratory impedance at 5 Hz (Z5Hz) and respiratory resistance at 5 and 20 Hz (R5Hz and R20Hz). No significant correlations were found between EBC biomarkers' changes and respiratory mechanics. CONCLUSION: This is the first study demonstrating that the changes in airway inflammation caused by EC have direct effects in respiratory mechanics of asthmatic patients.

An Indigenous Suction-assisted Laryngoscopy and Airway Decontamination Simulation System.

Background: Suction-assisted laryngoscopy and airway decontamination (SALAD) is a new modality and training manikins are quite costly. Few modifications have been described with their pluses and minuses. We describe a low-cost simulator that replicates fluid contamination of the airway at various flow rates and allows the practice of SALAD in vitro. Materials and methods: We modified a standard Laerdal airway management trainer with locally available equipment to simulate varying rates of continuous vomiting or hemorrhage into the airway during intubation. The effectiveness of our SALAD simulator was tested during an advanced airway workshop of the Airway Management Foundation (AMF). The workshop had a brief common presentation on the learning objective of the SALAD technique followed by a demonstration to small groups of 5-6 participants at one time with necessary instructions. This was followed by a hands-on practical learning session on the simulator. Results: One hundred and five learners used the simulator including 15 faculties and 90 participants (48 on ICU and 42 on ENT workstations). At the end of the session, the workshop faculty and participants were asked to rate their level of confidence in managing similar situations in real practice on a four-point Likert scale. All 15 faculty members and 70 out of 90 participants felt very confident in managing similar situations in real practice. Fifteen participants felt fairly confident and 5 felt slightly confident. Conclusion: In resource-limited settings, our low-cost SALAD simulator is a good educational tool for training airway managers in the skills of managing continuously and rapidly soiling airways. How to cite this article: Kumar R, Kumar R. An Indigenous Suction-assisted Laryngoscopy and Airway Decontamination Simulation System. Indian J Crit Care Med 2024;28(7):702-705.

Right trace wrong place: a normal capnography trace despite the tip of the tracheal tube existing outside the airway.

Head and neck trauma can result in difficult airway management. A 25-year-old male required emergency tracheal intubation on arrival to the emergency department following a motorbike accident. Despite the presence of a normal capnography a computed tomography scan demonstrated a tracheal opening, an extra-tracheal position of the distal end of the tracheal tube, and extensive subcutaneous emphysema. The tube was re-directed into the trachea and the tracheal injury was surgically repaired. This case highlights that the presence of a normal capnograph does not necessarily mean that the distal end of the tracheal tube resides within the airway.

Alternative Hybrid Technique of Intubation Using C-MAC and Yankauer Suction Catheter: Case of A Floppy Supraglottic Mass.

Supraglottic masses can be an anaesthesiologist's nightmare due to the difficult airway scenario and bleeding risk during airway manipulation. Awake fibreoptic intubation is the primary method to secure the airway in such cases. However, most practising anaesthesiologists are not experts at handling the fibreoptic scope, especially in cases with a floppy supraglottic mass where it becomes difficult to displace the mask with the thin flexible bronchoscope. A hybrid technique of intubation in supraglottic masses using Bonfils rigid scope and C-MAC is often described but frequently not available. Here we describe a case of an elderly patient in their 80s presenting with a floppy supraglottic mass where an awake fibreoptic bronchoscope failed to secure the airway. Without access to a rigid Bonfils scope, we intuitively used a C-MAC to visualize the larynx and a yankauer suction catheter to displace the mass and perform a bougie-guided endotracheal intubation.

National Implementation of CPAP Telemonitoring and a Pay-for-performance Scheme for Homecare Providers in France Leads to Prioritisation of Resources to Individuals with Low Therapy Adherence: The IMPACT-PAP Cohort Study.

INTRODUCTION: Long-term adherence to continuous positive airway pressure (CPAP) therapy for obstructive sleep apnoea remains suboptimal and low adherence increases healthcare costs. This study investigated relationships between CPAP adherence and the intensity of support provided by homecare providers after implementation of telemonitoring and pay-for-performance reimbursement for CPAP in France. METHODS: Adults who started CPAP in 2018/2019, used telemonitoring, and had ≥1 year of homecare provider data were eligible. The main objective was to determine associations between CPAP adherence at 1 month (low [<2h/night], intermediate [2 to <4h/night], high [≥4h/night]) and the number/type of homecare provider interactions (home visits, phone calls, mask change) during the first year. RESULTS: Eleven thousand, one hundred sixty-six individuals were included (mean age 59.8±12.7 years, 67% male). The number of homecare provider interactions per person increased significantly as 1-month CPAP usage decreased (7.65±4.3, 6.5±4.0, 5.4±3.4 in low, intermediate and high adherence groups; p<0.01). There was marked improvement in device usage over the first 5-6 months of therapy in the low and intermediate adherence subgroups (p<0.05 after adjustment for age, sex, initial CPAP adherence, and number of interactions). After adjustment for age, sex and 1-month adherence, having 3-4 interactions was significantly associated with better 1-year adherence (odds ratio 1.24, 95% confidence interval 1.05-1.46), while having >7 interactions was significantly associated with worse 1-year adherence. CONCLUSIONS: The telemonitoring/reimbursement scheme in France had a positive impact on CPAP adherence and facilitated a more personalised approach to therapy management, focusing resources on patients with low and intermediate adherence.

Graphene oxide-loaded rapamycin coating on airway stents inhibits stent-related granulation tissue hyperplasia.

OBJECTIVES: To explore the safety and efficacy of a graphene oxide-loaded rapamycin-coated airway stent (GO@RAPA-SEMS) in a rabbit model. METHODS: The dip coating method was used to develop GO@RAPA-SEMS and PLGA-loaded rapamycin coating airway stents (PLGA@RAPA-SEMS). The surface structure was evaluated by SEM. The in vitro drug release profiles of the two stents were explored and compared. In the animal study, a total of 45 rabbits were randomly divided into three groups and underwent 3 kinds of stent placement. Computed tomography was performed to evaluate the degree of stenosis at 1, 2, and 3 months poststent surgery. Five rabbits in each group were sacrificed after CT. The stented trachea and blood were collected for further pathological analysis and laboratory testing. RESULTS: The in vitro drug release study revealed that GO@RAPA-SEMS exhibited sudden release on the first day and maintained a certain release rate on the 14th day. The PLGA@RAPA-SEMS exhibited a longer sustained release time. All 45 rabbits underwent successful stent placement. Pathological results indicated that the granulation tissue thickness in the GO@RAPA-SEMS group was less than that in the PLGA@RAPA-SEMS group. The TUNEL and HIF-1α staining results support that the granulation inhibition effect in the GO@RAPA-SEMS group was greater than that in the PLGA@RAPA-SEMS group. CONCLUSIONS: GO@RAPA-SEMS effectively inhibited stent-related granulation tissue hyperplasia.

Risk Factors of Obstructive Sleep Apnea (OSA) in Pediatric Patients: A Systematic Review and Meta-analysis.

INTRODUCTION: This review aimed to assess the risk factors of Obstructive Sleep Apnea (OSA) in pediatric children, a common condition with serious long-term sequela. METHODS: PubMed, CENTRAL, Scopus, and Google Scholar were searched using the keywords "Apnea", "Obstructive Sleep" OR "Obstructive Sleep Apnea Syndrome" AND "Child" OR "Children" OR "Pediatrics". Data from 35 studies involving 497,688 pediatric patients diagnosed with OSA using polysomnography were reviewed. Risk factors examined included sex, obesity, neck circumference, tonsillar/adenoid hypertrophy, respiratory infections, nasal stenosis, parental OSA/smoking, ethnicity, preterm birth, and breastfeeding history. Relative Risk (RR) with 95% Confidence Intervals (95% CI) were calculated, using Cochrane Q and I² statistics to estimate heterogeneity. RESULTS: Tonsillar hypertrophy (RR = 3.55), adenoid hypertrophy (RR = 1.63), respiratory tract infection (RR = 2.59), obesity (RR = 1.74), and family history of OSA (RR = 3.03) were significantly associated with pediatric OSA. White ethnicity was protective (RR = 0.77). DISCUSSION: Recognizing these risk factors aids in early diagnosis and treatment of pediatric OSA.

Alteration of the airway microbiota is associated with the progression of post-COVID-19 chronic cough in adults: a prospective study.

Cough is one of the most common symptoms observed in patients presenting with COVID-19, persisting for an extended duration following SARS-CoV-2 infection. We aim to describe the distribution of airway microbiota and explore its role in patients with post-COVID-19 chronic cough. A total of 57 patients experiencing persistent cough after infection were recruited during the Omicron wave of SARS-CoV-2 in China. Airway microbiota profiling is assessed in nasopharyngeal swab, nasal lavage, and induced sputum samples at 4 and 8 weeks after SARS-CoV-2 infection. Our findings reveal that bacterial families Staphylococcaceae, Corynebacteriaceae, and Enterobacteriaceae are the most prevalent in the upper airway, while Streptococcaceae, Lachnospiraceae, and Prevotellaceae emerge as the most prevalent bacterial families in the lower airway. An increase in the abundance of Staphylococcus in nasopharyngeal swab samples and of Streptococcus in induced sputum samples is observed after one month. Furthermore, the abundance of Staphylococcus identified in nasopharyngeal swab samples at the baseline period emerges as an insightful predictor for improvement in cough severity. In conclusion, dynamic alterations in the airway microbial composition may contribute to the post-COVID-19 chronic cough progression, while the compositional signatures of nasopharyngeal microbiota could reflect the improvement of this disease.

Extracorporeal membrane oxygenation-facilitated palliative radiotherapy for severe airway obstruction due to lung cancer: A case report.

Background: The use of venovenous extracorporeal membrane oxygenation (VV-ECMO), particularly during radiotherapy, for severe malignant central airway obstruction has rarely been reported. Case Presentation: A 47-year-old female presented to our emergency department with severe respiratory distress. Given her medical history, she was initially diagnosed with asthma. Despite initial treatment, which included intubation, her condition deteriorated, necessitating VV-ECMO. Computed tomography performed following the initiation of VV-ECMO revealed extensive lung cancer involving both bronchial types. Radiotherapy while on VV-ECMO led to a significant reduction in tumor size, allowing for the weaning of ECMO support and successful extubation. Conclusion: Malignant central airway obstruction is life-threatening. Our case demonstrates the efficacy of combining VV-ECMO with radiotherapy when conventional therapies fail. Further research is necessary to validate and explore this novel approach's implications.

Utilization and Findings of Flexible Naso-Pharyngo-Laryngoscopy in Upper Airway Disorders: A Clinic Audit.

Background: Flexible naso-pharyngo-laryngoscopy (NPL) has become an essential clinic tool for evaluating patients with upper airway disorders in otorhinolaryngology. It has been established to be a simple, cost-effective, and minimally invasive technique with good diagnostic yields. This study aimed to audit the procedure of flexible NPL done in our clinic over 2 years and analyse the technique, indications, and findings of the procedure. Methodology: A retrospective cross-sectional study among all the patients who presented to our ENT clinic in ABUTH Zaria, from July 2021 to June 2023 with upper airway symptoms or neck swelling who had flexible NPL done in the clinic. The records of these patients were reviewed, and information extracted including age, sex, use of anaesthesia, indications and findings of the procedure were entered in SPSS and analysed. Results: Flexible NPL was done in 266 patients aged 4 months to 85 years. Only 3% of the patients required local anaesthesia. The commonest indications were for preoperative evaluation of goitre (26.7%), suspected adenoid hypertrophy (18.4%), complaints of hoarseness (18.8%), and foreign body sensation (12%). The commonest diagnoses made were adenoid hypertrophy (19.9%), laryngeal tumour (5.3%), nasopharyngeal tumour (4.9%), vocal cord palsy (4.9%), rhinitis (4.5%) and pharyngitis (4.1%), laryngitis (3.0%), laryngopharyngeal reflux disease (3.0%) and vocal cord nodule (2.3%). Conclusions: Office flexible NPL was done commonly for preoperative evaluation of goitre, suspected adenoid hypertrophy, hoarseness, and foreign body sensation. The commonest pathologies were adenoid hypertrophy, laryngeal tumour, nasopharyngeal tumour, vocal cord palsy, rhinitis, pharyngitis, and laryngitis.

Anesthetic Management of a Patient With Subglottic Stenosis: The Crucial Role of Communication Between Teams.

Subglottic stenosis is characterized by the narrowing of the airway at the inferior edge of the cricoid cartilage level. It is either congenital or acquired, the latter being more commonly secondary to internal iatrogenic trauma. Airway management of these cases is challenging and requires multidisciplinary discussion. We present a case of a 17-year-old boy scheduled for tracheostomy in the context of subglottic stenosis probably caused by prolonged endotracheal intubation. On the day of surgery, it was decided to perform an asleep fiberoptic visualization of the lesion through a supraglottic device, which revealed a narrow circumferential fibrous membrane just below the vocal cords. Given the findings, a suspension laryngoscopy accompanied by supraglottic manual jet ventilation was performed. Balloon dilatation with the application of mitomycin C was the elected otorhinolaryngologic technique. At the end of the procedure, a fiberoptic exam was performed and only a minimal portion of the membrane remained. The patient was asymptomatic on follow-up visits. We aim to raise awareness of how the anesthetic management of patients with subglottic stenosis may prove challenging. Communication between anesthetic and surgical teams is essential for the achievement of the main goal, which is the acquisition of an adequate airway that allows normal patient activity associated with minimal postoperative morbidity.

Optimizing Anesthesia for Extensive Extraoral Fungating Lesions: Strategies and Considerations.

A large extraoral fungus, frequently seen in late head and neck cancers, poses serious difficulties for the management of anesthesia and surgery. Essential factors include preoperative optimization, airway assessment, intraoperative monitoring, and postoperative care. Risk mitigation and outcome optimization strategies are discussed, including appropriate airway management and hemodynamic monitoring. Ideal patient outcomes in situations of extensive extraoral fungation can be attained by a complete plan that integrates surgical expertise and anesthetic care. This case discusses the successful anesthetic management of a 55-year-old man undergoing composite resection with segmental mandibulectomy, appropriate neck dissection, free fibular flap, and scalp flap for squamous cell carcinoma of the lower labial mucosa with significant extraoral fungation.

Acute Laryngeal Injury in Patients Undergoing Airway Screening at a Long-Term Acute Care Hospital.

BACKGROUND/OBJECTIVES: Acute laryngeal injury (ALgI) is an identified complication of prolonged intubation. Its evolution into mature stenosis and factors affecting decannulation are unclear. This retrospective review aims to characterize the incidence and characteristics of ALgI development and decannulation. METHODS: Retrospective study of post-intubated patients with a tracheostomy seen for screening evaluation at a single long-term acute care hospital (LTACH) from 2019 to 2022. RESULTS: Patients were followed for an average of 115 days after extubation. Forty-nine of 119 adult patients had ALgI. Those with ALgI were more likely female (61% vs. 35.7%, p = 0.006) with higher body mass index (BMI; 32.9 vs. 28.1, p = 0.03) and lower height (166 vs. 171.1 cm, p = 0.01). Decannulation rates in patients with ALgI were 69.4% compared to 84.3% in patients without ALgI (p = 0.053). Patients with ALgI were scoped more quickly post-extubation (28.8 vs. 36.6 days, p = 0.04), but time to decannulation did not differ (66.6 vs. 81.2 days, p = 0.74). Lower CCI (4.03 vs 6.93) and lack of tobacco use (41.2% vs 73.3%) were associated with successful decannulation (p = 0.038, p = 0.0008). Patients with ALgI treated conservatively (observation or medical management) were decannulated up to 71 days post-extubation. Further decannulations only occurred with surgical intervention. CONCLUSIONS: Female gender, higher BMI, and shorter height are associated with ALgI among patients undergoing a LTACH screening evaluation. CCI and tobacco have a negative association with decannulation success. Among the ALgI cohort, no patient treated conservatively was decannulated after 71 days. LEVEL OF EVIDENCE: 4 Laryngoscope, 2024.

The role of hormones in ILC2-driven allergic airway inflammation.

Group 2 innate lymphoid cells (ILC2s) are a type of innate immune cells that produce a large amount of IL-5 and IL-13 and two cytokines that are crucial for various processes such as allergic airway inflammation, tissue repair and tissue homeostasis. It is known that damaged epithelial-derived alarmins, such as IL-33, IL-25 and thymic stromal lymphopoietin (TSLP), are the predominant ILC2 activators that mediate the production of type 2 cytokines. In recent years, abundant studies have found that many factors can regulate ILC2 development and function. Hormones synthesized by the body's endocrine glands or cells play an important role in immune response. Notably, ILC2s express hormone receptors and their proliferation and function can be modulated by multiple hormones during allergic airway inflammation. Here, we summarize the effects of multiple hormones on ILC2-driven allergic airway inflammation and discuss the underlying mechanisms and potential therapeutic significance.

Sleep apnea after stroke: A novel target.

Sleep apnea is an independent risk factor for cerebrovascular diseases. Its prevalence in stroke survivors is high and the disorder negatively affects patients' outcomes. Despite the importance of sleep apnea assessment is highlighted also in the current guidelines, a high proportion of patients remain undiagnosed and lose the potential benefit of positive airway pressure treatment. The current paper describes links between sleep apnea and stroke. It focuses on the challenges of the diagnostic and therapeutical process and provides a brief insight into ongoing trials that could help to identify appropriate diagnostic and therapeutic approaches, their timing, and the patient population for whom treatment could be most beneficial.

Epidural Block in a Patient With Melkersson-Rosenthal Syndrome: A Case Report.

This case report describes the first known application of an epidural block for labor analgesia in a patient with Melkersson-Rosenthal syndrome (MRS), a rare disorder that may present sudden and threatening airway complications. A tailored epidural protocol effectively mitigated symptom exacerbation, facilitating a complication-free vaginal delivery. This report not only enriches the sparse literature on anesthesia in patients with MRS but also provides a crucial review of perioperative considerations for administering either general or regional anesthesia in similar cases.

Correlation between cone-beam computed tomographic findings and the apnea-hypopnea index in obstructive sleep apnea patients: A cross-sectional study.

Purpose: The aim of this study was to explore the correlations of cone-beam computed tomographic findings with the apnea-hypopnea index in patients with obstructive sleep apnea. Materials and Methods: Forty patients with obstructive sleep apnea were selected from the ear-nose-throat (ENT) outpatient clinic, Faculty of Medicine, Mansoura University. Cone-beam computed tomography was performed for each patient at the end of both inspiration and expiration. Polysomnography was carried out, and the apnea-hypopnea index was obtained. Linear measurements, including cross-sectional area and the SNA and SNB angles, were obtained. Four oral and maxillofacial radiologists categorized pharyngeal and retropalatal airway morphology and calculated the airway length and volume. Continuous data were tested for normality using the Kolmogorov-Smirnov test and reported as the mean and standard deviation or as the median and range. Categorical data were presented as numbers and percentages, and the significance level was set at P<0.05. Results: The minimal value of the cross-sectional area, SNB angle, and airway morphology at the end of inspiration demonstrated a statistically significant association (P<0.05) with the apnea-hypopnea index, with excellent agreement. No statistically significant difference was found in the airway volume, other linear measurements, or retropalatal airway morphology. Conclusion: Cone-beam computed tomographic measurements in obstructive sleep apnea patients may be used as a supplement to a novel radiographic classification corresponding to the established clinical apnea-hypopnea index classification.

Computational fluid dynamics (CFD), virtual rhinomanometry, and virtual surgery for neonatal congenital nasal pyriform aperture stenosis.

OBJECTIVES: Investigate the implications of Congenital Nasal Pyriform Aperture Stenosis (CNPAS) on neonatal nasal airflow through computational fluid dynamics (CFD), create a virtual rhinomanometry, and simulate the prospective outcomes post-virtual surgical intervention. METHODS: CT scanning of a neonate diagnosed with CNPAS and a control model were used to execute CFD simulations. The segmentation file of the CNPAS underwent manual modifications to simulate a virtual surgical procedure, resulting in a geometry that mirrors a post-operatively corrected patient. Virtual rhinomanometry was reconstructed, and airflow dynamics within the nasal cavity were systematically assessed. The results of the three models were compared. RESULTS: In the CNPAS model, airflow dynamics underwent discernible alterations, with the principal airflow corridor confined to the nasal cavity's upper region. There was a marked pressure drop around the nasal valve, and diminished velocities. This first model of virtual surgery has allowed us to observe that the airflow parameters trended toward the control model, reintroducing an airflow trajectory between the lower and middle turbinates. Virtual rhinomanometry presented near-complete nasal obstruction in the CNPAS model, which showed considerable improvement after the virtual surgery. CONCLUSION: CFD highlights the aerodynamic changes resulting from CNPAS. It also allows for the creation of virtual rhinomanometry and the performance of virtual surgeries. Virtual surgery confirms the therapeutic potential of pyriform aperture enlargement techniques used in clinical practice to improve nasal respiratory function. Future research will investigate additional surgical scenarios and the application of these findings to optimize surgical interventions for CNPAS.

Knowledge, attitudes and practices of nurses regarding airway clearance in neurocritical illness patients: A cross-sectional study.

AIM: We aimed to assess the level of knowledge, attitudes and practices regarding airway clearance among nurses and explore the factors affecting the knowledge, attitudes and practices. DESIGN: A questionnaire-based cross-sectional study. BACKGROUND: Airway clearance is an important method of eliminating excess secretions. In neuroscience nursing, nurses are important executors of airway management, and their knowledge, attitudes and practices can influence the effectiveness of airway clearance. METHODS: This study was conducted from July to September 2023 in four hospitals in Jiangsu Province, China. A structured questionnaire about airway clearance was designed and used to collect the data. The nurses used this questionnaire to self-rate. The STROBE checklist for cross-sectional studies was followed. RESULTS: The age, work experience, highest educational attainment and technical title of the nurses can significantly influence their knowledge. The age, highest educational attainment and technical title of the nurses can significantly impact their attitudes. Practice scores were significantly influenced by age, work experience, technical title, whether the nurses had received any training on airway clearance techniques, and whether the department developed procedures for implementing the airway clearance technology. Nurses' attitudes were significantly associated with knowledge and practice, and there was no significant correlation between knowledge and practice. CONCLUSION: This study showed that age, work experience, highest educational attainment and training were related to knowledge, attitudes and practices. These findings suggest that nursing managers can conduct airway clearance training according to age group, working experience and education level of the nurses. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution. IMPACT: The findings show that the level of knowledge, attitudes and practices related to airway clearance in neuroscience nursing among nurses were acceptable, which means that nurses can better perform airway management on patients. These findings serve as a significant reference for designing an airway clearance education for nurses and meet the needs of nurses in clinical nursing practice.