Management of Failed Intubation

Management of failed intubation
Session overview
Description
This session will describe the management of unanticipated difficult intubation including failed intubation. This can be a life-threatening scenario, especially in conjunction with an inability to oxygenate. This session will also introduce the 2015 Difficult Airway Society guidelines.

Learning objectives
By the end of this session you will be able to:

• define and recognise a difficult airway
• describe the management plan for an unanticipated difficult intubation
• describe the management plan of a failed intubation
• describe the management plan for the 'can't intubate, can't oxygenate' (CICO) scenario
• understand the importance of communication during these scenarios

Prerequisites
Before commencing this session you should:

• have a knowledge of laryngeal mask airways, tracheal intubation, the surgical airway and laryngeal anatomy

Problems with intubation and oxygenation are very stressful.

If managed poorly, problems with airway management can cause the patient to suffer soft tissue damage and, at worst, hypoxic brain damage and death.

Management must primarily concentrate on the prevention and treatment of hypoxaemia and not the act of intubation.

This session will cover the definitions and diagnosis of the difficult airway, and review the protocols designed by the Difficult Airway Society (DAS) to deal with these situations.

The seriousness and urgency of a failed intubation scenario is determined by whether or not it is possible to achieve adequate oxygenation.

Every patient should have an airway assessment pre-surgery to evaluate all aspects of airway management, including front of neck access.

Making and practising a back up airway plan before starting any anaesthetic is essential.