Difficult Airway Management Algorithm in Emergency Medicine: Do Not Struggle against the Patient, Just Skip to Next Step
We report a case of prehospital “cannot intubate” and “cannot ventilate” scenarios successfully managed by strictly following a difficult airway management algorithm. Five airway devices were used: the Macintosh laryngoscope, the gum elastic Eschmann bougie, the LMA Fastrach, the Melker cricothyroto...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2010-01-01
|
| Series: | Emergency Medicine International |
| Online Access: | http://dx.doi.org/10.1155/2010/826231 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850107085057949696 |
|---|---|
| author | Jérôme Sudrial Caroline Birlouez Anne-Laurette Guillerm Jean-Luc Sebbah Roland Amathieu Gilles Dhonneur |
| author_facet | Jérôme Sudrial Caroline Birlouez Anne-Laurette Guillerm Jean-Luc Sebbah Roland Amathieu Gilles Dhonneur |
| author_sort | Jérôme Sudrial |
| collection | DOAJ |
| description | We report a case of prehospital “cannot intubate” and “cannot ventilate” scenarios successfully managed by strictly following a difficult airway management algorithm. Five airway devices were used: the Macintosh laryngoscope, the gum elastic Eschmann bougie, the LMA Fastrach, the Melker cricothyrotomy cannula, and the flexible fiberscope. Although several airway devices were used, overall airway management duration was relatively short, at 20 min, because for each scenario, failed primary and secondary backup devices were quickly abandoned after 2 failed attempts, each attempt of no more than 2 min in duration, in favor of the tertiary rescue device. Equally, all three of these rescue devices failed, an uncuffed cricothyroidotomy cannula was inserted to restore optimal arterial oxygenation until a definitive airway was secured in the ICU using a flexible fiberscope. Our case reinforces the need to strictly follow a difficult airway management algorithm that employs a limited number of effective devices and techniques, and highlights the imperative for early activation of successive preplanned steps of the algorithm. |
| format | Article |
| id | doaj-art-4cbc5f4280df4d67aedea37ae7ed45e4 |
| institution | OA Journals |
| issn | 2090-2840 2090-2859 |
| language | English |
| publishDate | 2010-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Emergency Medicine International |
| spelling | doaj-art-4cbc5f4280df4d67aedea37ae7ed45e42025-08-20T02:38:39ZengWileyEmergency Medicine International2090-28402090-28592010-01-01201010.1155/2010/826231826231Difficult Airway Management Algorithm in Emergency Medicine: Do Not Struggle against the Patient, Just Skip to Next StepJérôme Sudrial0Caroline Birlouez1Anne-Laurette Guillerm2Jean-Luc Sebbah3Roland Amathieu4Gilles Dhonneur5Prehospital Emergency Medicine Department, General Hospital Gonesse, 95500, FrancePrehospital Emergency Medicine Department, General Hospital Gonesse, 95500, FrancePrehospital Emergency Medicine Department, General Hospital Gonesse, 95500, FrancePrehospital Emergency Medicine Department, General Hospital Gonesse, 95500, FranceAnesthesia and Intensive Care and Emergency Medicine Department, Jean Verdier University Hospital of Paris, 93143 Bondy, FranceAnesthesia and Intensive Care and Emergency Medicine Department, Jean Verdier University Hospital of Paris, 93143 Bondy, FranceWe report a case of prehospital “cannot intubate” and “cannot ventilate” scenarios successfully managed by strictly following a difficult airway management algorithm. Five airway devices were used: the Macintosh laryngoscope, the gum elastic Eschmann bougie, the LMA Fastrach, the Melker cricothyrotomy cannula, and the flexible fiberscope. Although several airway devices were used, overall airway management duration was relatively short, at 20 min, because for each scenario, failed primary and secondary backup devices were quickly abandoned after 2 failed attempts, each attempt of no more than 2 min in duration, in favor of the tertiary rescue device. Equally, all three of these rescue devices failed, an uncuffed cricothyroidotomy cannula was inserted to restore optimal arterial oxygenation until a definitive airway was secured in the ICU using a flexible fiberscope. Our case reinforces the need to strictly follow a difficult airway management algorithm that employs a limited number of effective devices and techniques, and highlights the imperative for early activation of successive preplanned steps of the algorithm.http://dx.doi.org/10.1155/2010/826231 |
| spellingShingle | Jérôme Sudrial Caroline Birlouez Anne-Laurette Guillerm Jean-Luc Sebbah Roland Amathieu Gilles Dhonneur Difficult Airway Management Algorithm in Emergency Medicine: Do Not Struggle against the Patient, Just Skip to Next Step Emergency Medicine International |
| title | Difficult Airway Management Algorithm in Emergency Medicine: Do Not Struggle against the Patient, Just Skip to Next Step |
| title_full | Difficult Airway Management Algorithm in Emergency Medicine: Do Not Struggle against the Patient, Just Skip to Next Step |
| title_fullStr | Difficult Airway Management Algorithm in Emergency Medicine: Do Not Struggle against the Patient, Just Skip to Next Step |
| title_full_unstemmed | Difficult Airway Management Algorithm in Emergency Medicine: Do Not Struggle against the Patient, Just Skip to Next Step |
| title_short | Difficult Airway Management Algorithm in Emergency Medicine: Do Not Struggle against the Patient, Just Skip to Next Step |
| title_sort | difficult airway management algorithm in emergency medicine do not struggle against the patient just skip to next step |
| url | http://dx.doi.org/10.1155/2010/826231 |
| work_keys_str_mv | AT jeromesudrial difficultairwaymanagementalgorithminemergencymedicinedonotstruggleagainstthepatientjustskiptonextstep AT carolinebirlouez difficultairwaymanagementalgorithminemergencymedicinedonotstruggleagainstthepatientjustskiptonextstep AT annelauretteguillerm difficultairwaymanagementalgorithminemergencymedicinedonotstruggleagainstthepatientjustskiptonextstep AT jeanlucsebbah difficultairwaymanagementalgorithminemergencymedicinedonotstruggleagainstthepatientjustskiptonextstep AT rolandamathieu difficultairwaymanagementalgorithminemergencymedicinedonotstruggleagainstthepatientjustskiptonextstep AT gillesdhonneur difficultairwaymanagementalgorithminemergencymedicinedonotstruggleagainstthepatientjustskiptonextstep |