A Retrospective Study of the Performance of Video Laryngoscopy in an Obstetric Unit

Aziz, Michael; Kim, Diana; Mako, Jeffrey; Hand, Karen; Brambrink, Ansgar M.

doi:10.1213/ane.0b013e3182642130

Cited by 38 publications

(22 citation statements)

References 11 publications

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“…In aggregate, these data suggest that the use of videolaryngoscopy as a rescue technique in the most challenging of airway situations plays a significant role, consistent with existing literature. 2,3,[16][17][18][19] Our data also offer the first empiric guidance on the value of the airway examination and patient history in predicting DMV combined with DL. We evaluated aspects of the patient history and physical examination (table 1) that have previously been demonstrated to be associated with either DMV or DL.…”

Section: Discussionmentioning

confidence: 69%

Incidence, Predictors, and Outcome of Difficult Mask Ventilation Combined with Difficult Laryngoscopy

et al. 2013

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Section: Discussionmentioning

confidence: 69%

Incidence, Predictors, and Outcome of Difficult Mask Ventilation Combined with Difficult Laryngoscopy

et al. 2013

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“…Currently, they are stocked in 90% of obstetric units in the UK [12]. In obstetric practice, videolaryngoscopes have been used at elective caesarean section, in morbidly obese patients and during failed intubation [116][117][118][119][120][121][122][123][124][125]. However, currently there are no comparative studies of the best videolaryngoscope for the obstetric population [126].…”

Section: First Intubation Attemptmentioning

confidence: 99%

Obstetric Anaesthetists’ Association and Difficult Airway Society Guidelines for the Management of Difficult and Failed Tracheal Intubation in Obstetrics

Mushambi¹,

Kinsella²,

Popat³

et al. 2016

Obstetric Anesthesia Digest

114

221

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SummaryThe Obstetric Anaesthetists' Association and Difficult Airway Society have developed the first national obstetric guidelines for the safe management of difficult and failed tracheal intubation during general anaesthesia. They comprise four algorithms and two tables. A master algorithm provides an overview. Algorithm 1 gives a framework on how to optimise a safe general anaesthetic technique in the obstetric patient, and emphasises: planning and multidisciplinary communication; how to prevent the rapid oxygen desaturation seen in pregnant women by advocating nasal oxygenation and mask ventilation immediately after induction; limiting intubation attempts to two; and consideration of early release of cricoid pressure if difficulties are encountered. Algorithm 2 summarises the management after declaring failed tracheal intubation with clear decision points, and encourages early insertion of a (preferably secondgeneration) supraglottic airway device if appropriate. Algorithm 3 covers the management of the 'can't intubate, can't oxygenate' situation and emergency front-of-neck airway access, including the necessity for timely perimortem caesarean section if maternal oxygenation cannot be achieved. Table 1 gives a structure for assessing the individual factors relevant in the decision to awaken or proceed should intubation fail, which include: urgency related to maternal or fetal factors; seniority of the anaesthetist; obesity of the patient; surgical complexity; aspiration risk; potential difficulty with provision of alternative anaesthesia; and post-induction airway device and airway patency. This decision should be considered by the team in advance of performing a general anaesthetic to make a provisional plan should failed intubation occur. The table is also intended to be used as a teaching tool to facilitate discussion and learning regarding the complex nature of decision-making when faced with a failed intubation. Table 2 gives practical considerations of how to awaken or proceed with surgery. The background paper covers recommendations on drugs, new equipment, teaching and training.

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“…This will enable understanding not just of how it works but recognition of those situations and airways where it may prove ineffective, as no VL is perfect. [70][71][72] Practice to develop, retain and be able to pass on skills is essential.…”

Section: Videolaryngoscopymentioning

confidence: 99%

The evolution of airway management – new concepts and conflicts with traditional practice

McNarry

Patel

2017

British Journal of Anaesthesia

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In the last 25 yr, there have been several advances in the safe management of the airway. Videolaryngoscopes and supraglottic airways, now in routine use by new trainees in anaesthesia, have had their genesis in the recent past. The 4th National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society published in 2011 a seminal report that has influenced airway management worldwide . Understanding how the report's recommendations were constructed and how clinical guidelines compliment rather than contradict them is important in understanding the tenets of safe airway management. Over the last 25 yr there has been an increasing understanding of the effects of human factors in anaesthesiology: we may not perform in a predictable or optimal manner when faced with unusual and threatening challenges. The place of cricoid pressure in anaesthetic practice has also evolved. Current recommendations are that it be applied, but it should be released rapidly should airway difficulty be encountered. The need to prevent hypoxaemia by preoxygenation has long been recognized, but the role of high-flow nasal oxygen in anaesthesia is now being realized and developed. Clinicians must decide how novel therapies and long-standing practices are adapted to best meet the needs of our patients and prevent harm during airway management.

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A Retrospective Study of the Performance of Video Laryngoscopy in an Obstetric Unit

Cited by 38 publications

References 11 publications

Incidence, Predictors, and Outcome of Difficult Mask Ventilation Combined with Difficult Laryngoscopy

Incidence, Predictors, and Outcome of Difficult Mask Ventilation Combined with Difficult Laryngoscopy

Obstetric Anaesthetists’ Association and Difficult Airway Society Guidelines for the Management of Difficult and Failed Tracheal Intubation in Obstetrics

The evolution of airway management – new concepts and conflicts with traditional practice

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