Trends in tracheal intubation: emphasis on the difficult airway

Abstract

This review will summarize the progress made during the last year in improving difficult-airway management. The UK Difficult Airway Society have published extensive guidelines for the management of unanticipated difficult intubation in the unobstructed adult patient. That such an approach is useful has been demonstrated in an independent study which showed that simple guidelines using familiar equipment will solve the majority of intubation difficulties likely to be encountered. However, their limitation lies in the fact that the worst-case scenario (i.e. inability to ventilate or intubate) is so rare that it cannot be studied systematically. It is postulated that a different approach geared to understanding the causes of difficulties with intubation may provide an alternative strategy for providing an evidence base. Significant steps have been made in our management of the difficult airway, and the majority of the problems encountered can be solved with recourse to simple published guidelines.