Thomas Heidegger1, Hans Jörg Gerig. 1. Department of Anaesthesia, Cantonal Hospital, St. Gallen, Switzerland. thomas.heidegger@kssg.ch
Abstract
PURPOSE OF REVIEW: The purpose of this review is to examine recent evidence for the management of the difficult airway. RECENT FINDINGS: Recent findings still recommend the importance of a predefined, simple strategy for both the anticipated and unanticipated difficult airway. For the former, awake fiberoptic intubation is still the 'gold standard'. For management of the unanticipated difficult airway, the use of the laryngeal mask airway (LMA), intubating laryngeal mask airway (ILMA), the 'gum elastic bougie' and fiber-optics are recommended. If intubation and ventilation fails, cannula or surgical cricothyroidotomy should be an early consideration. SUMMARY: This review of algorithms for management of the difficult airway strengthens several generally accepted crucial points. What is always needed is expertise, which one can only get and maintain by daily practice.
PURPOSE OF REVIEW: The purpose of this review is to examine recent evidence for the management of the difficult airway. RECENT FINDINGS: Recent findings still recommend the importance of a predefined, simple strategy for both the anticipated and unanticipated difficult airway. For the former, awake fiberoptic intubation is still the 'gold standard'. For management of the unanticipated difficult airway, the use of the laryngeal mask airway (LMA), intubating laryngeal mask airway (ILMA), the 'gum elastic bougie' and fiber-optics are recommended. If intubation and ventilation fails, cannula or surgical cricothyroidotomy should be an early consideration. SUMMARY: This review of algorithms for management of the difficult airway strengthens several generally accepted crucial points. What is always needed is expertise, which one can only get and maintain by daily practice.
Authors: Jolin Wong; John Song En Lee; Theodore Gar Ling Wong; Rehana Iqbal; Patrick Wong Journal: Singapore Med J Date: 2018-07-16 Impact factor: 1.858