| Abstrakt: |
Newer modalities for asleep airway management such as videolaryngoscopes and supraglottic airway devices have further advanced safe airway management but have not replaced awake tracheal intubation. However, time itself should not be the determining factor in cases where awake tracheal intubation is considered the safest approach, and the alternative, tracheal intubation attempt after induction of anaesthesia in a predicted difficult airway patient may well take longer, and bears the concomitant increased risk of having to revert to emergency front-of-neck access. It seems prudent to consider the nature of the pathology in these patients and come to a reassurance that asleep airway management is safe before induction of anaesthesia, and if not, then choose awake tracheal intubation. Yes, awake tracheal intubation with FB or VL may be difficult, or impossible, in the bleeding patient, but if the airway examination indicates an anatomically difficult airway then an awake approach, either awake tracheal intubation or awake front-of-neck access, is definitively as indicated as it would have been had the airway not been bleeding - or even more so [13]. [Extracted from the article] |
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