The 2015 Difficult Airway Society guidelines: what about the anticipated difficult airway? A reply

Pandit, J. J.; Marshall, Stuart

doi:10.1111/anae.13444

Cited by 3 publications

(1 citation statement)

References 5 publications

(5 reference statements)

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“…As such, we need a new guideline for the anticipated difficult airway". 14 In conclusion, anesthesiologists need simple awake intubation methods such as videolaryngoscopic intubation during which the whole procedure could be monitored, even the tube insertion. It is due time to try awake intubation with videolaryngoscopy as the primary technique for an anticipated difficult airway.…”

Section: Discussionmentioning

confidence: 99%

Awake Orotracheal Intubation with the McGrath Mac X-Blade in a Patient with Expected Difficult Airway

Arslan¹,

Zayakov²

2019

Turkiye Klinikleri J Case Rep

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he McGrath MAC (Medtronic Medical; Minneapolis, USA) is a portable videolaryngoscope with a slim designed X-Blade to improve difficult intubation situations without occupying much space. Its effectiveness in failed direct laryngoscopy in patients with limited mouth opening under general anaesthesia was demonstrated previously with case reports. 1,2 However, its performance in awake oro-tracheal intubation has not been validated. We have documented a successful awake orotracheal intubation in a truly difficult intubation who had cardiac arrests during his previous two operations under general anesthesia. CASE REPORTWe have documented a successful awake intubation with the McGrath MAC X-Blade ( Figure 1) in a patient with an expected difficult airway with a history of two cardiac arrests due to hypoxia during the previous two operations in a private hospital. His anesthesiologist reported that the patient had no hypoxia tolerance. The patient was also working as a member of the medical team. His preoperative visit in our hospital revealed that; he was a 25-year-old male patient with a weight of 58 kg and a height of 168 cm. He was undergoing laparoscopic abdominal testis exploration. He had Klinefelter disease (chromosomal condition) and growth disorder. He had no his-A AB BS S T TR RA AC CT T We managed a 25 year-old male undergoing laparoscopic abdominal testis exploration using awake McGrath MAC X-Blade videolaryngoscopy. He had Mallampati IV (with phonation), macroglossia, mandibular protrusion B, no ability for jaw thrust maneuver, limited head flexion and a wing scapula. Cardiac arrest had occurred during his previous surgery related to his impossible mask ventilation. The oropharynx was topicalized with a 10% lidocaine spray. Three ml of 2% lidocaine was administered from the cricothyroid membrane. A continuous remifentanil infusion was started at the same time. The patient was intubated successfully with a McGrath MAC X-Blade at the first attempt and with a stylet inserted into a standard polyvinylchloride endotracheal tube under cricoid pressure with a Cormack-Lehane grade 2a and minimal gag reflex. He was transferred to the intensive care unit with an airway exchange catheter in place. He was discharged in good condition into his service the day after surgery. K Ke ey yw wo or rd ds s: : Awake intubation; difficult; video laryngoscope; McGrath MAC; X-Blade; expected

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Section: Discussionmentioning

confidence: 99%

Awake Orotracheal Intubation with the McGrath Mac X-Blade in a Patient with Expected Difficult Airway

Arslan¹,

Zayakov²

2019

Turkiye Klinikleri J Case Rep

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Video laryngoscopy-assisted tracheal intubation in airway management

Liao

Liu

et al. 2018

Expert Review of Medical Devices

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Video laryngoscopy-assisted tracheal intubation devices have become alternatives to traditional laryngoscopes in recent years. This review will provide information on commonly used video laryngoscopes and their clinical applications in airway management. Areas covered: In this review, the differences between video laryngoscopy and direct laryngoscopy, and the utilization of video laryngoscopes in specific clinical settings are discussed. Expert commentary: Video laryngoscopy should be embraced as an initial approach to intubation in patients with suspected difficult airway. Acute care providers should be familiar with more than one intubation techniques so that a rescue attempt can be applied promptly. Continual practice and familiarity with new video laryngoscopes are still essential to maximize the effectiveness and minimize the complications of using these devices.

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How China Anesthesiologists document and communicate difficult airway management

Liu

Yang

Deng

et al. 2023

Preprint

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Background According to the Chinese Society of Anesthesiology, it is recommended that patients with difficult airways be documented and notified, which will provide healthcare professionals with a direct reference when managing airways. However, compliance with this initiative remains unclear. This study was conducted to investigate the current status and need for difficult airway notification at Plastic Surgery Hospital and to explore the factors contributing to noncompliance. Methods Anesthesiologists, surgeons, and patients in Plastic Surgery Hospital were administered separate questionnaires regarding notification of difficult airway management. Participants were surveyed regarding their attitudes and current practices regarding difficult airway notification. In addition, questions were asked regarding the barriers that contribute to noncompliance. Results A total of 632 valid responses were obtained and analyzed, giving a response rate of 99.21%. 399 patients (89.46%) felt it was very important for anesthesiologists to inform them about their difficult airway, and 91.03% felt it was very important for them to receive a letter of their airway assessment. However, twenty-two anesthesiologists (64.7%) reported verbally informing less than 50% of patients about their difficult airway after surgery, and only four anesthesiologists informed all patients they encountered. Most surgeons (91.22%) and anesthesiologists (91.18%) believe that it is vital to inform patients verbally, while 114 surgeons (77.03%) and 31 anesthesiologists (91.18%) believe that it is essential to complete a difficult airway notification alert. Among the factors causing noncompliance, 17 (34.69%) believed that absence of mandatory rules, 9 (18.37%) believed that increased workload, and 8 (16.33%) believed that notification methods were lacking. Conclusions The compliance to difficult airway notification remains low in Plastic Surgery Hospital despite the high incidence of difficult airways. Although anesthesiologists, surgeons, and patients are strongly in favor of it. Among the barriers to compliance were the absence of a well-developed notification system and a means of notification such as an alert form for difficult airways. This may spur the anesthesiology society to publish the notification system.

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The 2015 Difficult Airway Society guidelines: what about the anticipated difficult airway? A reply

Cited by 3 publications

References 5 publications

Awake Orotracheal Intubation with the McGrath Mac X-Blade in a Patient with Expected Difficult Airway

Awake Orotracheal Intubation with the McGrath Mac X-Blade in a Patient with Expected Difficult Airway

Video laryngoscopy-assisted tracheal intubation in airway management

How China Anesthesiologists document and communicate difficult airway management

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