Practical aspects and training in fibreoptic intubation

Lee, John Song En; Wong, Jolin; Iqbal, Rehana; Wong, Ten It; Wong, Patrick

doi:10.1016/j.tacc.2016.08.002

Cited by 10 publications

(5 citation statements)

References 101 publications

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“…31 However, awake FBI has been associated with airway obstruction or loss of airway control due to sedation and local anaesthetic topicalization. 60,66 The incidence of difficult and impossible facemask ventilation was higher in the LTH cases than that reported in the general population (29.6 vs. 1.4% and 1.4% vs. 0.16%, respectively). 69 Facemask ventilation may be more difficult as the LTH may distort the supraglottis, 2,19,23,25,26,36,38,39 or overhang the borders of the epiglottis and cause airway obstruction.…”

Section: Awake Tracheal Intubation May Be the Best Option For Known S...mentioning

confidence: 78%

“…Impingement and failure to railroad the tracheal tube occurred in 11 (23.4%) and two (4.3%) cases, respectively. FBI was also performed by way of a supraglottic airway (supraglottic airway guided intubation, SGI) 60 in 13 (14.1%) cases and had an overall technique success rate of 46.2%.…”

Section: Resultsmentioning

confidence: 99%

“…31 However, awake FBI has been associated with airway obstruction or loss of airway control due to sedation and local anaesthetic topicalization. 60,66…”

Section: Discussionmentioning

confidence: 99%

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Airway management of lingual tonsillar hypertrophy: A narrative review

Wong,

Sleigh

2023

Anaesth Intensive Care

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Lingual tonsillar hypertrophy is rarely identified on routine airway assessment but may cause difficulties in airway management. We conducted a narrative review of case reports of lingual tonsillar hypertrophy to examine associated patient factors, success rates of airway management techniques and complications. We searched the literature for anaesthetic management of cases with lingual tonsillar hypertrophy. We found 89 patients in various case reports, from which we derived 92 cases to analyse. 64% of cases were assessed as having a normal airway. Difficult and impossible face mask ventilation occurred in 29.6% and 1.4% of cases, respectively. Difficult intubation and failed intubation occurred in 89.1% and 21.7% of cases, respectively. Multiple attempts (up to six) at intubation were performed, with no successful intubation after the third attempt with direct laryngoscopy. Some 16.5% of patients were woken up and 4.3% required emergency front of neck access. Complications included oesophageal intubation (10.9%), bleeding (9.8%) and severe hypoxia (3.2%). Our findings show that severe cases of lingual hypertrophy may cause an unanticipated difficult airway and serious complications, including hypoxic brain damage and death. A robust airway strategy is required which includes limiting the number of attempts at laryngoscopy, and early priming and performance of emergency front of neck access if required. In patients with known severe lingual tonsillar hypertrophy, awake intubation should be considered.

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Section: Awake Tracheal Intubation May Be the Best Option For Known S...mentioning

confidence: 78%

Section: Resultsmentioning

confidence: 99%

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Airway management of lingual tonsillar hypertrophy: A narrative review

Wong,

Sleigh

2023

Anaesth Intensive Care

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“…Flexible, fibreoptic and video bronchoscopes provide a pivotal role in tracheal intubation and extubation, evaluation of upper and lower airways, examination of supraglottic airways, as well as tracheal tubes and tracheostomy tubes. [87][88][89][90][91] In addition, they are valuable tools for lower airway suctioning, foreign body retrieval and obtaining specimens. 91 Flexible bronchoscopes should be readily available for all areas performing advanced airway management.…”

Section: Contents Of Difficult Airway Trolleysmentioning

confidence: 99%

Updated guideline on equipment to manage difficult airways: Australian and New Zealand College of Anaesthetists

Endlich

Hore

Baker

et al. 2022

Anaesth Intensive Care

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The Australian and New Zealand College of Anaesthetists (ANZCA) recently reviewed and updated the guideline on equipment to manage a difficult airway. An ANZCA-established document development group, which included representatives from the Australasian College for Emergency Medicine and the College of Intensive Care Medicine of Australia and New Zealand, performed the review, which is based on expert consensus, an extensive literature review, and bi-nationwide consultation. The guideline (PG56(A) 2021, https://www.anzca.edu.au/getattachment/02fe1a4c-14f0-4ad1-8337-c281d26bfa17/PS56-Guideline-on-equipment-to-manage-difficult-airways ) is accompanied by a detailed background paper (PG56(A)BP 2021, https://www.anzca.edu.au/getattachment/9ef4cd97-2f02-47fe-a63a-9f74fa7c68ac/PG56(A)BP-Guideline-on-equipment-to-manage-difficult-airways-Background-Paper ), from which the current recommendations are reproduced on behalf of, and with the permission of, ANZCA. The updated 2021 guideline replaces the 2012 version and aims to provide an updated, objective, informed, transparent, and evidence-based review of equipment to manage difficult airways.

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“…The practical aspects and training (including ethico-legal concerns) in FOI are reviewed and discussed elsewhere. (8)…”

Section: Introductionmentioning

confidence: 99%

Fibreoptic intubation in airway management: a review article

Wong¹,

Lee²,

Wong³

et al. 2019

smedj

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Since the first use of the flexible fibreoptic bronchoscope, a plethora of new airway equipment has become available. It is essential for clinicians to understand the role and limitations of the available equipment to make appropriate choices. The recent 4th National Audit Project conducted in the United Kingdom found that poor judgement with inappropriate choice of equipment was a contributory factor in airway morbidity and mortality. Given the many modern airway adjuncts that are available, we aimed to define the role of flexible fibreoptic intubation in decision-making and management of anticipated and unanticipated difficult airways. We also reviewed the recent literature regarding the role of flexible fibreoptic intubation in specific patient groups who may present with difficult intubation, and concluded that the flexible fibrescope maintains its important role in difficult airway management.

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Practical aspects and training in fibreoptic intubation

Cited by 10 publications

References 101 publications

Airway management of lingual tonsillar hypertrophy: A narrative review

Airway management of lingual tonsillar hypertrophy: A narrative review

Updated guideline on equipment to manage difficult airways: Australian and New Zealand College of Anaesthetists

Fibreoptic intubation in airway management: a review article

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