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difficult airway trolley

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5.1.3 - Difficult Intubation Guidelines and Failed Airway Management
from Section 5.1 - Practical Respiratory System
- By Jo Hackney, Benjamin Post
Edited by Ned Gilbert-Kawai, The Royal Liverpool Hospital, Debashish Dutta, Princess Alexandra Hospital NHS Trust, Harlow, Carl Waldmann, Royal Berkshire Hospital, Reading
Book:

Intensive Care Medicine

Published online:

27 July 2023

Print publication:

01 December 2021, pp 526-533
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Summary

Key Learning Points
1. Poor airway assessment and planning and failure to follow guidelines were highlighted as major issues in the Royal College of Anaesthetists 4th National Audit Project (NAP4). A lack of equipment was identified as an issue particularly prevalent in the intensive care environment.
2. Factors which enable prediction of a difficult airway should be assessed for early to allow appropriate forward planning.
3. It is important to have a well-organised, appropriately stocked and signposted difficult airway trolley, with regular teaching and updates to ensure all staff groups are familiar with the equipment.
4. Thorough knowledge of the Difficult Airway Society’s guidelines on how to manage an unpredicted difficult airway in adults is essential. As of 2018, these include one specific to the intensive care unit – ‘Guidelines for the management of tracheal intubation in critically ill adults’.
5. One must be able to appreciate the differences in emergency management of a tracheostomy (with a patent upper airway) and a laryngectomy (without a patent upper airway).