Chapter 11 - Algorithms for Management of the Difficult Airway

Abstract

Management of the difficult airway is one of the most challenging situations for anesthesiologists and all other practitioners who perform anesthesia care or airway management, since loss of the airway can lead to brain damage or even death. Specific strategies for difficult airway management can be linked together to form more comprehensive treatment plans or algorithms. However, there is not enough data to support the selection of a particular strategy in these various algorithms. Although no airway algorithm can be practiced in its entirety on a regular basis, anesthesiologists and other practitioners who perform anesthesia care or airway management must incorporate the use of alternative devices and techniques into their routine practice so that they can develop the confidence and skill required for their successful use in an emergency setting. The regular use of a carefully selected number of devices and techniques is a prerequisite to both acquire and maintain the appropriate expertise. Many adverse airway events occur due to the lack of anticipation, strategy (human factors and ergonomics), training, or adequate equipment for difficult airway management. After difficult airway management, appropriate follow-up and communication should be performed so that future caretakers will not unwittingly reproduce the same experience and risk.