Emergency airway management in the post anesthesia care unit

Airway management is one of the most challenging aspects in the field of anesthesia. This is also the case when an emergency airway situation arises in the postoperative patient. These airway procedures are often classified as advanced with high complexity. This article aims to address emergency airway management in the post anesthesia care unit.

The way in which care and supervision are organized in the post anesthesia care unit (PACU) varies between hospitals. Airway management in the PACU has typical challenges related to the team, the location itself, and assembling the necessary equipment for airway rescue. Crew resource management is an important aspect of care in these situations.

This article focuses on emergency airway management in the post anesthesia-care unit. A questionnaire for risk assessment and improvement of quality of care is presented. Different types of emergencies are discussed, i.e., due to medication, medical conditions (e.g., obstructive sleep apnea, pulmonary problems, stridor), procedural related emergencies (e.g., neurosurgery, head and neck surgery) and cardiac arrest. Each specific cause of emergency needs a different approach. A PACU airway rescue flowchart is presented.