We conclude that the video laryngoscope and GlideScope in particular may be useful instruments in the management of the predicted difficult airway.

No abstract

Since the publication of the first german guidelines on airway management in 2014, new techniques have been established in the clinical routine and new insights into existing strategies have been published. As a consequence the new guidelines on airway management of the German Society of Anesthesiology and Intensive Care Medicine represent the current state of scientific knowledge and integrate the currently recommended techniques and strategies. The aim of these guidelines is to guarantee an optimal care of patients undergoing anesthesiological procedures and serve as an orientation and decision aid for users.

No abstract

DGAInfo 294 Aus den Verbänden News | Information | Events DGAInfo Aus dem Wiss. Arbeitskreis Notfallmedizin der DGAI und der Kommission Atemwegs management der DGAI Handlungsempfehlung für das präklinische Atemwegsmanagement*

SummaryTracheal intubation with the intubating laryngeal mask airway or the Bonfils intubation fibrescope was performed in 80 patients with predicted difficult airways. Mallampati score, thyromental distance, mouth opening and mobility of the atlanto-occipital joint were used to predict difficult airways. The overall success rate, time to the first adequate lung ventilation and time taken for the successful placement of the tracheal tube were recorded, as well as a subjective assessment of the handling of the device and the incidence of postoperative sore throat and hoarseness.

SummaryFailed tracheal intubation due to a difficult airway is an important cause of anaesthetic morbidity and mortality. This study was undertaken to evaluate the effectiveness of the Bonfils intubation fibrescope for tracheal intubation after failed direct laryngoscopy. Twenty-five patients undergoing coronary artery bypass grafting were enrolled in the study after two attempts at conventional laryngoscopy by a board certified anaesthetist had failed. Intubation with the Bonfils fibrescope was successful on the first attempt in 22 patients (88%) and on the first or second attempt in 24 patients (96%); in one patient intubation was impossible. Median (IQR [range]) time to intubation using the Bonfils intubation fibrescope was 47.5 (30-80 [20-200]) s. Tracheal intubation using the Bonfils intubation fibrescope appears to be a simple and effective technique for the management of a difficult intubation.

Paramedics were able to employ the laryngeal mask airway, Combitube, and cuffed oropharyngeal airway in apneic patients with normal lung compliance and airways. In this population, bag-valve-mask ventilation was the most simple and successful strategy. Small tidal volumes applied with a pediatric self-inflating bag and 100% oxygen resulted in adequate oxygenation and ventilation.