The Other Side of the Difficult Airway: A Disciplined, Evidence-based Approach to Emergence and Extubation

Successful intubation of the patient with a difficult airway marks the beginning of the challenges facing the nurse anesthetist charged with delivery of that patient's anesthesia care. Too often, on successful intubation of this patient, the anesthetist and other members of the perioperative team may relax too much. Substantial planning and consultations have been employed to achieve the successful intubation of the patient with the difficult airway. Yet frequently, the final aspect of any general anesthetic-extubation-does not receive sufficient planning even though there continues to be a large volume of critical airway incidents surrounding the extubation and transportation of such a patient to the postanesthesia care unit.