Airway

2009 ◽  
pp. 65-104

Difficult mask ventilation 66 Unanticipated difficult intubation 68 Can’t intubate … can’t ventilate (CICV) 76 Emergency management of the obstructed airway 80 Rapid sequence induction 86 Oesophageal intubation 90 Bronchial intubation 92 Laryngospasm 94 Aspiration 96 Difficult tracheal extubation 100 Airway fire 102 Unexpected difficulty in mask ventilation of the anaesthetized patient....

2020 ◽  
pp. 79-117
Author(s):  
Jules Cranshaw ◽  
Tim Cook

This chapter covers the guidelines for airway emergencies in anaesthesia. Strategies, checklists, and flowcharts are presented for the management of unexpected difficult mask ventilation and difficult intubation, e.g. ‘Cannot intubate, cannot oxygenate’ (CICO) and front of neck airway (FONA), partial airway obstruction, rapid sequence induction, laryngospasm, endobronchial intubation, oesophageal intubation, aspiration, airway fire, and difficult tracheal extubation. Definitions, presentation, management strategies, investigations, risk factors, exclusions and causes, and any special considerations (e.g. paediatric implications) for each airway-related situation are covered. Lists of up-to-date online resources and further reading are also provided here, offering invaluable know-how to encourage the reader to broaden their knowledge.


2021 ◽  
pp. 361-404
Author(s):  
Jules Cranshaw ◽  
Emira Kursumovic ◽  
Tim Cook

This chapter provides detailed, practical and up-to-date information on management of the airway. It demystifies airway terminology, outlines airway assessment, and describes the management of the unanticipated difficult airway in adults. It includes a new section on intubating critically ill patients using the vortex approach, and outlines the equipment and techniques used to aid airway management. It gives practical information on the emergency front of neck airway and strategies to approach the obstructed airway. It explains rapid sequence induction, inhalational induction, awake tracheal intubation, and extubation after difficult intubation. It contains new sections on apnoeic oxygenation and how to manage patients with airborne respiratory viruses.


F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 1683
Author(s):  
Paul Baker

Effective mask ventilation is an essential skill for any practitioner engaged in airway management. Recent methods to objectively describe mask ventilation using waveform capnography help practitioners to monitor and communicate the effectiveness of mask ventilation. Gentle mask ventilation is now considered acceptable during rapid sequence induction/intubation after loss of consciousness, hence reducing the incidence of hypoxia prior to tracheal intubation. Mask ventilation can be enhanced with muscle relaxation, a double C-E grip, and jaw thrust. This is particularly relevant for patients with reduced apnoea time. An awareness of the complications associated with mask ventilation may help reduce the morbidity associated with this technique. Effective ventilation technique and optimum device selection are important aspects for resuscitation of the newborn. Teaching correct establishment and maintenance of mask ventilation is essential for safe patient care. This review will examine some of the latest developments concerning mask ventilation for adult and paediatric patients.


Author(s):  
Jules Cranshaw ◽  
Tim Cook

This chapter discusses the assessment and management of the airway. It begins with methods of assessing the airway and describes the approach to the unanticipated difficult airway. Topics covered include failed intubation, techniques for managing the anticipated difficult intubation, the cannot-intubate-cannot-ventilate scenario, the management of the obstructed airway, rapid sequence induction, inhalational induction, and awake fibreoptic intubation. It concludes with a discussion of extubating the patient after a difficult intubation.


Author(s):  
Jules Cranshaw ◽  
Tim Cook

This chapter discusses the assessment and management of the airway. It begins with methods of assessing the airway and describes the approach to the unanticipated difficult airway. Topics covered include failed intubation, techniques for managing the anticipated difficult intubation, the cannot-intubate-cannot-ventilate scenario, the management of the obstructed airway, rapid sequence induction, inhalational induction, and awake fibreoptic intubation. It concludes with a discussion of extubating the patient after a difficult intubation.


Author(s):  
Jakob Zeuchner ◽  
Jonas Graf ◽  
Louise Elander ◽  
Jessica Frisk ◽  
Mats Fredrikson ◽  
...  

Author(s):  
Pascale Avery ◽  
Sarah Morton ◽  
James Raitt ◽  
Hans Morten Lossius ◽  
David Lockey

Abstract Background Rapid Sequence Induction (RSI) was introduced to minimise the risk of aspiration of gastric contents during emergency tracheal intubation. It consisted of induction with the use of thiopentone and suxamethonium with the application of cricoid pressure. This narrative review describes how traditional RSI has been modified in the UK and elsewhere, aiming to deliver safe and effective emergency anaesthesia outside the operating room environment. Most of the key aspects of traditional RSI – training, technique, drugs and equipment have been challenged and often significantly changed since the procedure was first described. Alterations have been made to improve the safety and quality of the intervention while retaining the principles of rapidly securing a definitive airway and avoiding gastric aspiration. RSI is no longer achieved by an anaesthetist alone and can be delivered safely in a variety of settings, including in the pre-hospital environment. Conclusion The conduct of RSI in current emergency practice is far removed from the original descriptions of the procedure. Despite this, the principles – rapid delivery of a definitive airway and avoiding aspiration, are still highly relevant and the indications for RSI remain relatively unchanged.


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