Key Points The consequences of a difficult airway (DA) may include minor or major adverse medical events or death, professional liability to the practitioner, and direct and indirect costs to the patient and healthcare system. DA still accounts for the…
Key Points Maintaining expertise in airway management is the responsibility of every airway practitioner. This responsibility extends throughout one’s professional career and reaches far beyond the formative years of medical training into lifelong learning to stay competent. The essential ingredients…
Key Points Serious complications of airway management result from not recognizing the degree of airway difficulty. To minimize injury to the patient, the airway practitioner should examine the patient’s airway carefully, identify potential problems, devise a plan that involves the…
KEY POINTS Careful planning of tracheal extubation or tube exchange is as vital as the planning required for intubation. Airway complications are as common after tube removal as during insertion. Anticipating a successful extubation is an inexact science. Any emergent…
KEY POINTS The most reliable method for determining the intratracheal location of an endotracheal tube (ETT) is direct visualization of the tube passing through the vocal cords; flexible scope assessment can define the specific location of the ETT in the…
Key Points The indications for mechanical ventilation include hypoxemic and hypercapnic respiratory failure, altered mentation with patient inability to protect the airway, hemodynamic instability, and maintenance of adequate oxygenation and ventilation during deep sedation, general anesthesia, or neuromuscular blockade. Positive…
Key Points Polyurethane endotracheal tube (ETT) cuffs that have high-volume/low-pressure (HVLP) cuffs can conform to the irregular borders of the tracheal lumen and, therefore, are more effective at preventing microaspiration. ETT placement has mechanical and physiologic consequences. Vigilant surveillance of…
Key Points Intensive care unit (ICU) patients’ airways are extremely demanding; airway-related mortality and severe morbidity may be orders of magnitude higher than in general OR practice. Difficult airway (DI) is at least twice as common. Airway intervention must be…
KEY POINTS Specific training for non-operating room anesthesia (NORA) should be incorporated into anesthesia residency programs. Monitoring for both oxygenation and ventilation is required during sedation, including the use of capnography. Intubation of the patient with an anticipated difficult airway…
Key Points Regional anesthesia can provide an alternative to general anesthesia for certain surgical procedures; these includes surgeries to the thoracic and abdominal cavities and wall, and surgery to the extremities. The surgeries should be of limited duration (i.e., not…