scholarly journals Difficult Airway Management Algorithm in Emergency Medicine: Do Not Struggle against the Patient, Just Skip to Next Step

2010 ◽  
Vol 2010 ◽  
pp. 1-3 ◽  
Author(s):  
Jérôme Sudrial ◽  
Caroline Birlouez ◽  
Anne-Laurette Guillerm ◽  
Jean-Luc Sebbah ◽  
Roland Amathieu ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Airway Management ◽  
Difficult Airway ◽  
Macintosh Laryngoscope ◽  
Difficult Airway Management ◽  
Arterial Oxygenation ◽  
Management Algorithm ◽  
Early Activation ◽  
Airway Devices

We report a case of prehospital “cannot intubate” and “cannot ventilate” scenarios successfully managed by strictly following a difficult airway management algorithm. Five airway devices were used: the Macintosh laryngoscope, the gum elastic Eschmann bougie, the LMA Fastrach, the Melker cricothyrotomy cannula, and the flexible fiberscope. Although several airway devices were used, overall airway management duration was relatively short, at 20 min, because for each scenario, failed primary and secondary backup devices were quickly abandoned after 2 failed attempts, each attempt of no more than 2 min in duration, in favor of the tertiary rescue device. Equally, all three of these rescue devices failed, an uncuffed cricothyroidotomy cannula was inserted to restore optimal arterial oxygenation until a definitive airway was secured in the ICU using a flexible fiberscope. Our case reinforces the need to strictly follow a difficult airway management algorithm that employs a limited number of effective devices and techniques, and highlights the imperative for early activation of successive preplanned steps of the algorithm.

scholarly journals An Algorithm for Difficult Airway Management, Modified for Modern Optical Devices (Airtraq Laryngoscope; LMA CTrach ™)

2011 ◽  
Vol 114 (1) ◽  
pp. 25-33 ◽  
Author(s):  
Roland Amathieu ◽  
Xavier Combes ◽  
Widad Abdi ◽  
Loutfi El Housseini ◽  
Ahmed Rezzoug ◽  
...  
Keyword(s):  
Tracheal Intubation ◽  
Airway Management ◽  
Difficult Airway ◽  
Macintosh Laryngoscope ◽  
Patient Characteristics ◽  
Routine Practice ◽  
Difficult Airway Management ◽  
Management Algorithm ◽  
Airway Devices ◽  
Risk Of Aspiration

Background Because algorithms for difficult airway management, including the use of new optical tracheal intubation devices, require prospective evaluation in routine practice, we prospectively assessed an algorithm for difficult airway management that included two new airway devices. Methods After 6 months of instruction, training, and clinical testing, 15 senior anesthesiologists were asked to use an established algorithm for difficult airway management in anesthetized and paralyzed patients. Abdominal, gynecologic, and thyroid surgery patients were enrolled. Emergency, obstetric, and patients considered at risk of aspiration were excluded. If tracheal intubation using a Macintosh laryngoscope was impossible, the Airtraq laryngoscope (VYGON, Ecouen, France) was recommended as a first step and the LMA CTrach™ (SEBAC, Pantin, France) as a second. A gum elastic bougie was advocated to facilitate tracheal access with the Macintosh and Airtraq laryngoscopes. If ventilation with a facemask was impossible, the LMA CTrach™ was to be used, followed, if necessary, by transtracheal oxygenation. Patient characteristics, adherence to the algorithm, efficacy, and early complications were recorded. Results Overall, 12,225 patients were included during 2 yr. Intubation was achieved using the Macintosh laryngoscope in 98% cases. In the remainder of the cases (236), a gum elastic bougie was used with the Macintosh laryngoscope in 207 (84%). The Airtraq laryngoscope success rate was 97% (27 of 28). The LMA CTrach™ allowed rescue ventilation (n = 2) and visually directed tracheal intubation (n = 3). In one patient, ventilation by facemask was impossible, and the LMA CTrach™ was used successfully. Conclusions Tracheal intubation can be achieved successfully in a large cohort of patients with a new management algorithm incorporating the use of gum elastic bougie, Airtraq, and LMA CTrach™ devices.

The “inverted traffic light” obstetric difficult airway management algorithm

2012 ◽  
Vol 26 (6) ◽  
pp. 491-492 ◽  
Author(s):  
Tiberiu Ezri ◽  
Marian Weisenberg ◽  
Yitzhak Cohen ◽  
Shmuel Evron ◽  
Krzysztof M. Kuczkowski
Keyword(s):  
Airway Management ◽  
Difficult Airway ◽  
Difficult Airway Management ◽  
Traffic Light ◽  
Management Algorithm

scholarly journals Making the transition in difficult airway management: are new perspectives in critical emergency medicine nurses curricula needed?

Resuscitation ◽  
2019 ◽  
Vol 142 ◽  
pp. e64
Author(s):  
Ileana Lulic ◽  
Saqr AlHemeiri ◽  
AlAnood Bin Sulaiman ◽  
Afaf Sayed Jaafer ◽  
Mirna Diab ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Airway Management ◽  
Difficult Airway ◽  
Difficult Airway Management

scholarly journals Tracheal Intubation with Aura-i and aScope-2: How to Minimize Apnea Time in an Unpredicted Difficult Airway

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Vittorio Pavoni ◽  
Valentina Froio ◽  
Alessandra Nella ◽  
Martina Simonelli ◽  
Lara Gianesello ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Tracheal Intubation ◽  
Airway Management ◽  
Difficult Airway ◽  
Laryngeal Mask ◽  
Difficult Airway Management ◽  
Ventilation Technique ◽  
The Subject ◽  
Airway Devices ◽  
Entire Procedure

The supraglottic airway’s usefulness as a dedicated airway is the subject of continuing development. We report the case of an obese patient with unpredicted difficult airway management in which a new “continuous ventilation technique” was used with the Aura-i laryngeal mask and the aScope-2 devices. The aScope-2/Aura-i system implemented airway devices for the management of predictable/unpredictable difficult airway. The original technique required the disconnection of the mount catheter from Aura-i, the introduction of the aScope-2 into the laryngeal mask used as a conduit for video assisted intubation and then towards the trachea, followed by a railroading of the tracheal tube over the aScope-2. This variation in the technique guarantees mechanical ventilation during the entire procedure and could prevent the risk of hypoventilation and/or hypoxia.

scholarly journals Difficult Airway Trolleys for the Critical Care Unit

2010 ◽  
Vol 11 (2) ◽  
pp. 98-103 ◽  
Author(s):  
Paul Jeanrenaud ◽  
Vandana Girotra ◽  
Tim Wharton ◽  
Norman Main ◽  
Rifat Konuralp ◽  
...  
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Airway Management ◽  
Difficult Airway ◽  
Critical Care Unit ◽  
Intensive Care Society ◽  
Difficult Airway Management ◽  
Management Algorithm ◽  
Operating Theatres ◽  
Standards And Guidelines

Airway management is paramount to patient safety in critical care. Intensive Care Society (ICS) standards state that all critical care areas should have a designated difficult airway trolley (DAT) equivalent to that found in operating theatres. We conducted a national survey to determine compliance with this guideline. Adult intensive care units (ICUs) were questioned about the presence of a DAT, its contents and airway training for clinicians. Two hundred and sixty-two ICUs responded to the survey (90%), of which 130 (50%) had a designated DAT. In 38 (29%), a difficult airway management algorithm was available. Capnography was unavailable in 51 (40%) units with a DAT. Compliance with ICS standards and guidelines should be encouraged with respect to DATs. DATs should be available for immediate use within the ICU. Staff should be trained in the use of DAT equipment and be familiar with a difficult airway management algorithm.

scholarly journals A Modified Difficult Airway Management Algorithm Incorporating Video Devices in Routine Anesthesia Practice

2011 ◽  
Vol 115 (2) ◽  
pp. 442-444 ◽  
Author(s):  
Fu-Shan Xue ◽  
Xu Liao ◽  
Yu-Jing Yuan ◽  
Qiang Wang ◽  
Jian-Hua Liu
Keyword(s):  
Airway Management ◽  
Difficult Airway ◽  
Difficult Airway Management ◽  
Anesthesia Practice ◽  
Management Algorithm
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