Book contents
- Frontmatter
- Contents
- Acknowledgements
- List of Contributors
- Foreword
- Preface
- 1 Introduction: anaesthetic practice. Past and present
- 2 Risk assessment
- 3 ECG monitoring in the recovery area
- 4 The use of cricoid pressure during anaesthesia
- 5 Anaesthetic breathing circuits
- 6 Deflating the endotracheal tube pilot cuff
- 7 How aware are you? Inadvertent awareness under anaesthesia
- 8 Aspects of perioperative neuroscience practice
- 9 Resuscitation
- 10 Intravenous induction versus inhalation induction for general anaesthesia in paediatrics
- 11 Managing difficult intubations
- 12 Obstetric anaesthesia
- 13 Understanding blood gases
- 14 Total intravenous anaesthesia
- 15 Anaesthesia and electro-convulsive therapy
- 16 Mechanical ventilation of the patient
- 17 Perioperative myocardial infarction
- 18 Developing a portfolio
- 19 Accountability in perioperative practice
- Index
- References
11 - Managing difficult intubations
Published online by Cambridge University Press: 13 August 2009
- Frontmatter
- Contents
- Acknowledgements
- List of Contributors
- Foreword
- Preface
- 1 Introduction: anaesthetic practice. Past and present
- 2 Risk assessment
- 3 ECG monitoring in the recovery area
- 4 The use of cricoid pressure during anaesthesia
- 5 Anaesthetic breathing circuits
- 6 Deflating the endotracheal tube pilot cuff
- 7 How aware are you? Inadvertent awareness under anaesthesia
- 8 Aspects of perioperative neuroscience practice
- 9 Resuscitation
- 10 Intravenous induction versus inhalation induction for general anaesthesia in paediatrics
- 11 Managing difficult intubations
- 12 Obstetric anaesthesia
- 13 Understanding blood gases
- 14 Total intravenous anaesthesia
- 15 Anaesthesia and electro-convulsive therapy
- 16 Mechanical ventilation of the patient
- 17 Perioperative myocardial infarction
- 18 Developing a portfolio
- 19 Accountability in perioperative practice
- Index
- References
Summary
Key learning points
Available aids and techniques for both predicted and unexpected failed or difficult intubations
The importance of preoperative airway assessment and its impact on induction
Introduction
As the anaesthetic assistant's role develops, with opportunities arising for some to become non-medical anaesthetists (anaesthesia practitioner), preoperative assessments are already being carried out by anaesthetic assistants in a number of hospitals. This chapter aims to outline the prediction and management of difficult intubations for the participant, be it junior anaesthetist, non-medical anaesthetist or anaesthetic assistant. For those who will not be assessing or managing difficult airways, this chapter will provide valuable insight and enable the anaesthetic assistant to anticipate the needs of the anaesthetist.
A preoperative visit from the anaesthetist is appreciated by patients and has been shown to be more effective in reducing anxiety than premedication. The aim of the preoperative assessment is to ensure the patient's health is optimal and any potential difficulties during anaesthesia are anticipated. In the United Kingdom, it has traditionally been the role of the anaesthetist to perform the assessment of the airway and subsequent procedure of intubation for elective surgery, although no test is 100% reliable in predicting difficult intubation.
A history of previous difficult intubation is important, but a history of straightforward intubation some years earlier may be falsely reassuring. Whether we like it or not, we all change physically with age; increasing weight, reduced spinal flexion or changing disease processes means possible implications for airway management.
- Type
- Chapter
- Information
- Core Topics in Operating Department PracticeAnaesthesia and Critical Care, pp. 110 - 118Publisher: Cambridge University PressPrint publication year: 2007