The compromised airway: recognition and management

Unanticipated difficulties continue to occur in airway management. While newer systems of evaluation show some promise, the problem of poor predictive value limits their usefulness. Newer radiological techniques are useful for the assessment of patients with known pathology or anatomical difficulty but are of little help when unexpected problems arise. Several new tools are available which aid management of both anticipated and unanticipated airway problems. The anaesthetist should have a clear "fall back" plan of which of these techniques to use in emergency or urgent situations. Published algorithms may aid in the selection of appropriate techniques, but the anaesthetist must also develop dexterity with the particular technique chosen.