Out-of-OR Airway Management: Anticipating and Mitigating Physiologic Difficulty

Abstract

Committee News| June 2023 Out-of-OR Airway Management: Anticipating and Mitigating Physiologic Difficulty Craig S. Jabaley, MD, FCCM; Craig S. Jabaley, MD, FCCM Search for other works by this author on: This Site PubMed Google Scholar Catherine M. Kuza, MD, FASA, FCCM; Catherine M. Kuza, MD, FASA, FCCM Search for other works by this author on: This Site PubMed Google Scholar Jarva Chow, MD, MPH; Jarva Chow, MD, MPH Search for other works by this author on: This Site PubMed Google Scholar Nathan J. Smischney, MD, MSc, FASA Nathan J. Smischney, MD, MSc, FASA Search for other works by this author on: This Site PubMed Google Scholar ASA Monitor June 2023, Vol. 87, 30–31. https://doi.org/10.1097/01.ASM.0000938848.86076.f4 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn Email Cite Icon Cite Get Permissions Search Site Citation Craig S. Jabaley, Catherine M. Kuza, Jarva Chow, Nathan J. Smischney; Out-of-OR Airway Management: Anticipating and Mitigating Physiologic Difficulty. ASA Monitor 2023; 87:30–31 doi: https://doi.org/10.1097/01.ASM.0000938848.86076.f4 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll PublicationsASA Monitor Search Advanced Search Topics: airway maintenance, intubation As a discipline, anesthesiology has served to meaningfully advance patient safety. In this context, airway management in dedicated procedural settings has benefited from algorithmic guidance, novel pharmaceuticals, and technological advancements. Out of the OR, however, myriad physiologic and contextual factors conspire to complicate airway management. Such intubations are often emergent, performed in patients who are unstable, and require the clinician to work in suboptimal conditions with little time to prepare or examine the patient (West J Emerg Med 2015;16:1109-17). A recent international prospective observational study (INTUBE) of 2,964 critically ill adults undergoing intubation in the ICU demonstrated that physiologic difficulty associated with airway management is more common than technical, or anatomic, difficulty (JAMA 2021;325:1164-72). Peri-intubation cardiovascular instability accompanied 42.6% of all intubations, followed by severe hypoxemia in 9.3%, and cardiac arrest in 3.1%. Meanwhile, only 4.5% of intubations required more than two attempts, and only five... You do not currently have access to this content.