Difficult airway algorithm

The American Society of Anesthesiologists (ASA) released their much anticipated difficult airway guidelines. 

The new guidelines emphasize following- 

  • Oxygenation prior to and throughout attempts at airway management.
  • Use of end tidal COafter each attempt at airway management, regardless of the airway device or technique used. The role of clinical measures (eg, chest rise and fall, misting, skin color) are considered secondary to CO2 detection.
  • Airway management attempts with each device or technique should be limited to three, with another attempt permitted by a more experienced airway operator.

Most failed airways cases are result of inadequate evaluation prior to attempting airway management, failure to plan for difficult intubation, failure to use a supraglottic airway for rescue, delay in calling for help, and perseveration on failed techniques.

 

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