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Managing Difficult Airways

Managing Difficult Airways

To successfully deliver anesthesia to a patient during surgery, the anesthetist and surrounding experts must understand how to manage airways and proceed with caution when complications occur. While the risk of experiencing a difficult airway is relatively rare, according to the the British Journal of Anesthesia, there’s still a chance that anesthetists are faced with this problem.

In this article, we’ll assess what defines a difficult airway and how physicians and anesthetists can properly manage the issue through interventions:

What Defines Difficult Airway?
As stated in the “Practice Guidelines for Management of the Difficult Airway: An Updated Report by the American Society of Anesthesiologists Task Force on the Management of the Difficult Airway,” the difficult airway is defined as the clinical situation in which a trained anesthesiologist experiences an issue facilitating face mask ventilation of either the upper airway or tracheal intubation of the patient. This may occur due to patient factors, the clinical setting, or even the skills of the professional delivering anesthesia.

Can Physicians and Anesthesiologists Prepare in Advance?
To better prepare for anesthesia and ensure difficult airway doesn’t occur, physicians can take precautionary measures before the surgery or procedure. The following guidelines are recommended by the American Society of Anesthesiologists:

  1. Evaluate the patient’s medical history – Reviewing patient medical records may help identify a previous issue with difficult airway. Certain patient characteristics may also preface the likelihood of experiencing a difficult airway during surgery.
  2. Perform a pre-procedure physical examination – By conducting a pre-procedure physical examination, physicians may be able to identify upper airway pathologies or anatomical anomalies that could predict the occurrence of difficult airway. A physical examination is strongly suggested before any procedure to ensure the surgery goes smoothly.
  3. Consider additional diagnostics test – Performing certain diagnostics tests such as radiology, computed tomography scans or fluoroscopy may identify certain acquired or congenital features that indicate a patient has a difficult airway. Diagnostics testing should be strongly considered if patients’ medical history and pre-procedure physical examination predicts a difficult airway.

Before going into surgery, anesthesiologists should ensure proper management equipment is available in case of a difficult airway. They should also inform the patient of the risk and assign a professional to provide assistance if a difficult airway is encountered with supplemental oxygen.

Physicians can prepare for difficult airway by evaluating the patient's medical history before the procedure.Physicians can prepare for difficult airway by evaluating the patient’s medical history before the procedure.

How Can You Manage Difficult Airway?
There are various noninvasive interventions anesthesiologists can consider if difficult airway occurs. These include:

Awake intubation – A breathing tube device is placed down the breathing passage through the nose or mouth while the patient is awake.

Video-assisted laryngoscopy – A breathing tube is inserted through the nose or mouth, while images of the journey are displayed on a monitor and can be recorded for later viewing.

Tube-changers – Device used to exchange an endotracheal tube with a laryngoscope to assist the patient’s airway.

SGA – A device that forms a seal around the larynx to facilitate increased ventilation pressure to maintain adequate gas exchange in the patient.

Rigid laryngoscope blades – Blades come in a variety of sizes to accommodate the patient. Devices are used to properly examine the interior of the larynx.

Fiberoptic-guided intubation – A small endotracheal tube is threaded through an oral or nasal airway to properly facilitate breathing.

Light wands – Technique that uses a surgical light to guide tracheal intubation through the nose or mouth.

It’s important to remember, however, that any of these methods could increase one’s risk for experiencing cross-contamination when reusable devices are utilized during procedures. Single-use devices can provide the solution for a safe and effective intubation.

Facilitate Tracheal Intubation with OBP Medical
To help providers and health care organization better manage difficult airways in patients, OBP Medical has created SURE-SCOPE Single-Use Lighted Laryngoscope. It’s designed to help facilitate tracheal intubation during general anesthesia or cardiopulmonary resuscitation. Additionally, this single-use product reduces cost, increase efficiency and eliminates the risk of cross-contamination that comes with utilizing reusable laryngoscope blades, handles and light sources.  Request your SURE-SCOPE sample today.

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