The 2004 Difficult Airway Society guidelines for the management of difficult tracheal intubation: revolutionary and enduring

Anaesthesia ◽  
2021 ◽  
Vol 76 (7) ◽  
pp. 991-994
Author(s):  
T. M. Cook ◽  
E. O’Sullivan ◽  
F. E. Kelly
Keyword(s):  
Tracheal Intubation ◽  
Difficult Airway ◽  
Difficult Tracheal Intubation

scholarly journals Awake Fiberoptic or Awake Video Laryngoscopic Tracheal Intubation in Patients with Anticipated Difficult Airway Management

2012 ◽  
Vol 116 (6) ◽  
pp. 1210-1216 ◽  
Author(s):  
Charlotte V. Rosenstock ◽  
Bente Thøgersen ◽  
Arash Afshari ◽  
Anne-Lise Christensen ◽  
Claus Eriksen ◽  
...  
Keyword(s):  
Tracheal Intubation ◽  
Difficult Airway ◽  
Scale Score ◽  
Visual Analog Scale ◽  
Difficult Intubation ◽  
Visual Analog Scale Score ◽  
Difficult Tracheal Intubation ◽  
Fiberoptic Intubation ◽  
Analog Scale ◽  
Intubation Success

Background Awake flexible fiberoptic intubation (FFI) is the gold standard for management of anticipated difficult tracheal intubation. The purpose of this study was to compare awake FFI to awake McGrath® video laryngoscope, (MVL), (Aircraft Medical, Edinburgh, Scotland, United Kingdom) intubation in patients with an anticipated difficult intubation. The authors examined the hypothesis that MVL intubation would be faster than FFI. Methods Ninety-three adult patients with anticipated difficult intubation were randomly allocated to awake FFI or awake MVL, patients were given glycopyrrolate, nasal oxygen, topical lidocaine orally, and a transtracheal injection of 100 mg lidocaine. Remifentanil infusion was administered intravenously to a Ramsay sedation score of 2-4. Time to tracheal intubation was recorded by independent assessors. The authors also recorded intubation success on the first attempt, investigators' evaluation of ease of the technique, and patients reported intubation-discomfort evaluated on a visual analog scale. Results Eighty-four patients were eligible for analysis. Time to tracheal intubation was median [interquartile range, IQR] 80 s [IQR 58-117] with FFI and 62 s [IQR 55-109] with MVL (P = 0.17). Intubation success on the first attempt was 79% versus 71% for FFI and MVL, respectively. The median visual analog scale score for ease of intubation was 2 (IQR 1-4) versus 1 (IQR 1-6) for FFI and MVL, respectively. The median visual analog scale score for patients' assessment of discomfort for both techniques was 2, FFI (IQR 0-3), MVL (IQR 0-4). Conclusions The authors found no difference in time to tracheal intubation between awake FFI and awake MVL intubation performed by experienced anesthesiologists in patients with anticipated difficult airway.

scholarly journals All India Difficult Airway Association 2016 guidelines for the management of unanticipated difficult tracheal intubation in obstetrics

2016 ◽  
Vol 60 (12) ◽  
pp. 899 ◽  
Author(s):  
Ekambaram Dinesh ◽  
Venkateswaran Ramkumar ◽  
SumalathaRadhakrishna Shetty ◽  
Amit Shah ◽  
Pankaj Kundra ◽  
...  
Keyword(s):  
Tracheal Intubation ◽  
Difficult Airway ◽  
Difficult Tracheal Intubation

scholarly journals All India Difficult Airway Association 2016 guidelines for the management of unanticipated difficult tracheal intubation in Paediatrics

2016 ◽  
Vol 60 (12) ◽  
pp. 906 ◽  
Author(s):  
JesonRajan Doctor ◽  
DilipK Pawar ◽  
UbaradkaS Raveendra ◽  
Singaravelu Ramesh ◽  
SumalathaRadhakrishna Shetty ◽  
...  
Keyword(s):  
Tracheal Intubation ◽  
Difficult Airway ◽  
Difficult Tracheal Intubation

Predictors of difficult endotracheal intubation in the emergency department: a single-center pilot study

2020 ◽  
Keyword(s):  
Emergency Department ◽  
Tracheal Intubation ◽  
Airway Obstruction ◽  
Difficult Airway ◽  
Endotracheal Intubation ◽  
Upper Airway ◽  
Difficult Tracheal Intubation ◽  
Upper Airway Obstruction ◽  
Cutoff Score ◽  
Difficult Endotracheal Intubation

Background: Identifying patients who are at risk of difficult endotracheal intubation is crucial in the emergency department. Therefore, this study evaluated the incidence and predictive factors of difficult tracheal intubation in the emergency department. Methods: This was a 17-month prospective observational study. A difficult airway was defined as Cormack & Lehane classification grades III and IV at the first attempt of intubation. Patients who visited the emergency department, underwent traditional endotracheal intubation from participating physicians, and provided informed consent by themselves or via their delegates were enrolled in this study. Univariate associations between patient characteristics and difficult endotracheal intubation were identified, and statistically significant factors were included in a multivariate binary logistic regression model. A generalized association plot was used to show the relationships between variables. Results: A total of 110 patients were enrolled in the study. The incidence of difficult intubation was 35.5% (39/110). In the difficult airway group, significantly higher body mass index (BMI), and incidence of double chin, thick short neck, Mallampati difficulty, small interincisor distance, small thyromental distance, and upper airway obstruction were noted on univariate analysis. A predictive formula for difficult tracheal intubation was successfully established by the combination of four independent predictors: BMI (odds ratio [OR] = 1.270), thyromental distance (OR = 0.614), upper airway obstruction (OR = 4.038), and Mallampati difficulty (OR = 5.163). A cutoff score of four maximized Youden’s index, providing sensitivity (79.5%) and specificity (81.7%) (95% CI: 0.794 to 0.938). Conclusions: We used four predictors of difficult tracheal intubation, namely, BMI, thyromental distance, upper airway obstruction, and Mallampati difficulty, to create a predictive formula. This formula could help emergency physicians to quickly identify and carefully manage patients with difficult endotracheal intubation and consult experts early if necessary.

scholarly journals All India Difficult Airway Association 2016 guidelines for the management of unanticipated difficult tracheal intubation in adults

2016 ◽  
Vol 60 (12) ◽  
pp. 885 ◽  
Author(s):  
SheilaNainan Myatra ◽  
Amit Shah ◽  
Pankaj Kundra ◽  
Apeksh Patwa ◽  
Venkateswaran Ramkumar ◽  
...  
Keyword(s):  
Tracheal Intubation ◽  
Difficult Airway ◽  
Difficult Tracheal Intubation

scholarly journals Secrets to a successful awake fibreoptic intubation (AFOI) on a patient with odentogenous abscess

2021 ◽  
Vol 14 (2) ◽  
pp. e238600
Author(s):  
Ming Kai Teah ◽  
Esther Huey Ring Liew ◽  
Melvin Teck Fui Wong ◽  
Tat Boon Yeap
Keyword(s):  
Tracheal Intubation ◽  
Airway Management ◽  
Difficult Airway ◽  
Patient Outcomes ◽  
Fibreoptic Intubation

Awake fibreoptic intubation (AFOI) is an established modality in patients with anticipated difficulty with tracheal intubation. This case demonstrates that with careful and meticulous preparations, AFOI can lead to improved airway management and excellent patient outcomes. A 38-year-old woman presented with severe trismus secondary to odentogenous abscess was identified preoperatively as having a potential difficult airway. AFOI was performed successfully using combined Spray-As-You-Go and dexmedetomidine technique.

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