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The algorithm provides a step-by-step framework to respond to situations where traditional airway management techniques may be inadequate. Current guidelines for airway management when inducing anesthesia where ventilation is inadequate recommend to call for help and limit attempts at tracheal intubation to three attempts plus one attempt by an ...
In anaesthesia and advanced airway management, rapid sequence induction (RSI) – also referred to as rapid sequence intubation or as rapid sequence induction and intubation (RSII) or as crash induction [1] – is a special process for endotracheal intubation that is used where the patient is at a high risk of pulmonary aspiration.
The anaesthesia community had been calling for practice guidelines and in 1992 the ASA commissioned a task force to establish practice guidelines for managing difficult airway situations. The ASA algorithm for difficult airways was published in 1993 and stressed an early attempt at insertion of the laryngeal mask if face mask ventilation was ...
Management of the airway in the emergency department is optimal given the presence of trained personnel from multiple specialties, as well as access to "difficult airway equipment" (videolaryngoscopy, eschmann tracheal tube introducer, fiberoptic bronchoscopy, surgical methods, etc.). [4]
The Simplified Airway Risk Index (SARI), or El-Ganzouri Risk Index (EGRI), is a multivariate risk score thought to estimate the risk of difficult tracheal intubation. The SARI score ranges from 0 to 12 points, where a higher number of points indicates a more difficult airway. A SARI score of 4 or above is thought to indicate a difficult ...
A systematic review of 42 studies, with 34,513 participants, found that the modified Mallampati score is a good predictor of difficult direct laryngoscopy and intubation, but poor at predicting difficult bag mask ventilation.
[4] [5] However, traditional airway management education has not included the integration of a simultaneous suctioning and airway decontamination skill set as a technique that can be deployed in the setting of large volume contamination and clinicians frequently underestimate the importance of suction as part of airway management. [1] [6] [7]
[13] [14] The double-lumen laryngeal tube-Suction II, with the possibility of placing a gastric tube, has been found to have distinct advantages over the standard laryngeal tube and has been recommended as a first-line device to secure the airway in emergency situations when direct laryngoscopy fails in neonates and infants. [15]