difficult airway

plan A

  • Tracheal intubation

maximise chance of success by:

  • Optimise head and neck position
  • Preoxygenate
  • Adequate neuromuscular blockade
  • Direct / Video Laryngoscopy (maximum 3+1 attempts)
  • External laryngeal manipulation
  • Bougie
  • Remove cricoid pressure
  • Maintain oxygenation and anaesthesia

If fail, move to

plan B

  • Supraglottic airway device
  • IF SUCCEED, consider:
  1. Wake the patient up
  2. Intubate trachea via the SAD
  3. Proceed without intubating the trachea
  4. Tracheostomy or cricothyroidotomy

If fail, move to

plan C

  • Face mask ventilation - 2 person technique
  • Paralyse
  • IF SUCCEED: wake patient up

plan D

#airway #anaesthetics #perioperative #ent

https://database.das.uk.com/files/das2015intubation_guidelines.pdf

Cricothyroidotomy
Tracheostomy emergencies

"wake patient up" doesn't really work for the ED intubations tho?