Planning for a difficult airway

Emergency intubations are the most dangerous 10 minutes in the hospital. The difficult airway is just the type of low frequency, high consequence event that scares the crap out of me.

Cliff Reid, from Sydney, has an awesome blog where he recently interviewed the author of the Major complications of airway management in the UK. This report on every reported airway complication reads like a horror novel. 

The report has a ton of recommendations, but the best summary is PLAN to FAIL.

I‟m working our difficult airway plans, and am trying to help us plan for difficult and failed airways. Better skills, more practice, and more toys would be nice, but a good plan is probably the most important step.

In the near future, we will talking about planning for difficult airways and creating our own algorithm. For now, check out the resources below, including educational videos on the bougie and emergency crics. -Andy

Br J Anaesth. 2011 May;106(5):632-42.

Want to review some of your difficult airway skills? Below are some links to on- line procedure reviews. There is a lot more out there.

Using the Bougie for Oral Intubation

From the emergent procedure instructional collaboration

The 5-step cricothyrotomy by HQMedEd

From HQMedEd

Bougie aided cricothyrotomy from EMCrit

By Darren Braude