TY - JOUR
T1 - Recent trends in tracheal intubation
T2 - Emphasis on the difficult airway
AU - Ezri, Tiberiu
AU - Szmuk, Peter
PY - 2004/12
Y1 - 2004/12
N2 - Purpose of review: Difficult airways can lead to critical incidents during anaesthesia, and death. Although many cases can be anticipated, some still go undiscovered before induction, thereby exposing the patient to unexpected risks and the anaesthesiologist to unexpected challenges. In addition to improving prediction of difficult airways, education for skill acquisition and management planning, and a quest for superior management techniques and airway tools are of the utmost importance in preventing airway catastrophes. Recent findings: We review recent advances in predicting difficult airways in special population groups that are known to have a higher incidence of difficult airway. Education, exercising airway skills, management planning with both predicted and unpredicted difficult airways, and the need for adherence to algorithms for management of difficult airway are emphasized as key to successful management. Finally, recent developments in airway management techniques and new airway devices are summarized. Summary: Improving reproducibility and reliability in predicting a difficult airway may limit the number of unpredicted difficult intubations. A safer approach to management of the difficult airway can be achieved by improving airway management skills and adhering to universally accepted and proven airway algorithms, including developing approaches to management of predicted and unpredicted difficult airways. Improving on existing airway techniques and tools (of which there are many), rather than creating new devices, is a desirable trend that may contribute to safer airway management in the future.
AB - Purpose of review: Difficult airways can lead to critical incidents during anaesthesia, and death. Although many cases can be anticipated, some still go undiscovered before induction, thereby exposing the patient to unexpected risks and the anaesthesiologist to unexpected challenges. In addition to improving prediction of difficult airways, education for skill acquisition and management planning, and a quest for superior management techniques and airway tools are of the utmost importance in preventing airway catastrophes. Recent findings: We review recent advances in predicting difficult airways in special population groups that are known to have a higher incidence of difficult airway. Education, exercising airway skills, management planning with both predicted and unpredicted difficult airways, and the need for adherence to algorithms for management of difficult airway are emphasized as key to successful management. Finally, recent developments in airway management techniques and new airway devices are summarized. Summary: Improving reproducibility and reliability in predicting a difficult airway may limit the number of unpredicted difficult intubations. A safer approach to management of the difficult airway can be achieved by improving airway management skills and adhering to universally accepted and proven airway algorithms, including developing approaches to management of predicted and unpredicted difficult airways. Improving on existing airway techniques and tools (of which there are many), rather than creating new devices, is a desirable trend that may contribute to safer airway management in the future.
KW - Airway devices
KW - Difficult airway
KW - Implications
KW - Management techniques
KW - Prediction
KW - Teaching
UR - http://www.scopus.com/inward/record.url?scp=10344224082&partnerID=8YFLogxK
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U2 - 10.1097/00001503-200412000-00006
DO - 10.1097/00001503-200412000-00006
M3 - Review article
C2 - 17031081
AN - SCOPUS:10344224082
SN - 0952-7907
VL - 17
SP - 487
EP - 490
JO - Current opinion in anaesthesiology
JF - Current opinion in anaesthesiology
IS - 6
ER -