Current practice for awake fibreoptic intubation ‐ some unanswered questions

Current practice for awake fibreoptic intubation - asking the right questions

“…El-Boghdadly et al described their experience with awake fibreoptic intubation (AFOI) performed on 600 patients [1]. As more clinicians embrace the actual or perceived efficacy of indirect videolaryngoscopy for the difficult airway, the authors must be congratulated for studying an essential technique whose relevance is increasingly likely to be questioned [2].…”

“…We would like to thank Drs. Murphy and Howes for their thoughtful editorial, which accompanied our recent study of awake fibreoptic intubation (AFOI) practice [1,2], and for recognising the training opportunities that our institution provides. However, rather than alluding to unanswered questions in our data, we are concerned that they have applied conjecture and inference to ask the wrong questions about AFOI.…”

3‐D printing in anaesthesia: challenges and controversies

“…Furthermore, a model will allow practitioners to practice manoeuvres to negotiate difficult anatomy, without traumatising the airway and while experiencing physical feedback that is absent in virtual endoscopy [3]. The 4th National Audit Project (NAP4) highlighted the deficit in fibreoptic intubation training and assessment, which has also recently been discussed [4,5]. We aim to create a 3-D printed, airway simulator with interchangeable modules based on real patient CT data to tackle this problem.…”

“…All-in-one editing suites such as Mimics (Materialise, Leuven, Belgium) are comprehensive and have been used with success in previous airway modelling, but often come with expensive licensing agreements [5,6]. Fortunately, there is a huge range of software applications, freely downloadable online to aid with segmentation, STL (standard tessellation language) file conversion, computeraided design and image slicing.…”

Continued utility of awake fibreoptic intubation

“…As El‐Boghdadly et al. and Murphy and Howes observe, training in AFOI is advisable for all anaesthesia trainees, and their study's detailing of the grades of trainee performing AFOI, together with their complication rates, is a useful addition to the literature. Our own 2015 retrospective study of 1554 AFOIs, also at a tertiary care teaching centre, included AFOIs performed by attending consulting staff or their trainees under supervision , as did Joseph et al.…”