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A Novel Rescue Technique for Difficult Intubation and Difficult Ventilation
Published on: January 17, 2011
The unanticipated difficult airway with recommendations for management
E T Crosby1, R M Cooper, M J Douglas
1Department of Anaesthesia, University of Ottawa, Ontario. ecrosby@fox.nstn.ca
Canadian Journal of Anaesthesia = Journal Canadien D'Anesthesie
|October 30, 1998
Summary
Newer airway management technologies, like the laryngeal mask and lighted stylet, are effective for unanticipated difficult airways. Integrating these devices improves patient outcomes and should become the standard of care with proper training.
Area of Science:
- Anesthesiology
- Airway Management
- Medical Devices
Background:
- The unanticipated difficult airway presents a consistent challenge in anesthesia practice.
- Difficult direct laryngoscopy and intubation occur in 1.5-8.5% and 0.13-0.3% of general anesthetics, respectively.
- Current prediction techniques for airway difficulty have limited accuracy.
Purpose of the Study:
- To review current literature on newer technologies for managing unanticipated difficult airways.
- To generate evidence-based recommendations for the role of these technologies.
Main Methods:
- Conducted a literature search of Medline, Current Contents, and Biological Abstracts (1990-1996).
- Focused on English language and abstracted publications.
- Reviewed and condensed literature to develop recommendations.
Main Results:
- Devices like the laryngeal mask, lighted stylet, and rigid fiberoptic laryngoscopes are effective in difficult airway scenarios.
- These devices can reduce morbidity and are occasionally lifesaving.
- The laryngeal mask and Combitube are effective in "cannot ventilate" situations; lighted stylets and Bullard scopes aid in failed intubations.
Conclusions:
- Newer airway management devices are effective alternatives when standard methods fail.
- Integration of these devices into difficult airway management strategies is recommended as the new standard of care.
- Training programs must include these alternative devices for physicians.
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