Practice Guidelines for Management of the Difficult Airway: An Updated Report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway

  title={Practice Guidelines for Management of the Difficult Airway: An Updated Report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway},
  author={Jeffrey L. Apfelbaum and Carin A. Hagberg and Robert A. Caplan and Casey D. Blitt and Richard T. Connis and David G. Nickinovich and Jonathan L. Benumof and Frederic A. Berry and Robert H. Bode and Frederick W. Cheney and Orin F. Guidry and Andranik Ovassapian},
RACTICE Guidelines are systematically developed recommendations that assist the practitioner and patient in making decisions about health care. These recommendations may be adopted, modified, or rejected according to clinical needs and constraints and are not intended to replace local institutional policies. In addition, Practice Guidelines developed by the American Society of Anesthesiologists (ASA) are not intended as standards or absolute requirements, and their use cannot guarantee any… 

Updated difficult airway algorithm: confusing and contradictory.

Omitting a critical component such as the aspiration risk assessment from this latest version may subject patients to undue risk, especially as skills with awake techniques like flexible bronchoscopy seem to be continually deemphasized in the literature for various reasons.

The Role of Awake Intubation

The principles discussed herein generally apply to a wide variety of clinical settings apart from anesthesia, requiring management of a suspected or known difficult airway.

[Management of the difficult airway : Overview of the current guidelines].

Although there is no evidence to support the selection of a particular approach, the importance and the need for a defined airway concept/algorithm in any anesthesia department is fostered.

Difficult airway consultation service for children: steps to implement and preliminary results

This report outlines the steps to establish the Difficult Airway Service (DAS) and the initial experiences with this new consultation service.

Airway Management of the Critically Ill Patient: Modifications of Traditional Rapid Sequence Induction and Intubation

Acknowledgement of variations in RSI practice allows the development of institutional procedures, with potential for future consensus recommendations guided by both published studies and expert opinion.

The evolution of airway management ‐ new concepts and conflicts with traditional practice

Clinicians must decide how novel therapies and long‐standing practices are adapted to best meet the needs of the authors' patients and prevent harm during airway management.

The Difficult Airway: A New Simplified Approach to an Old Complex Problem

This narrative review attempts to summarize, organize and consolidate current trends and supported recommendations of the updated guidelines in one practical, concise and unified guide, proposing a simple, intuitive and novel algorithm.

Is there a gold standard for management of the difficult airway?




The airway: problems and predictions in 18,500 patients

It is concluded that difficult tracheal intubations occurred infrequently but were associated with increased morbidity and dental damage on induction of anaesthesia.

Pre-anesthetic evaluation can play a crucial role in the determination of airway management in a child with oropharyngeal tumor

The importance of referring to an airway management algorithm when encountering a difficult airway is discussed, including semi-awake induction to secure the airway in an 11-year-old child with a huge hemangioma.

Airway Management Using the Intubating Laryngeal Mask Airway for the Morbidly Obese Patient

Results of this study suggest that using the ILMA provides an additional technique for airway management of morbidly obese patients.

Clinical assessment of the Augustine Guide for endotracheal intubation.

The Augustine Guide is a safe and effective tool for blind orotracheal intubation and is described as easy if they were successful in the first attempt and difficult when more than one attempt to position the AG was necessary.

Criteria for estimating likelihood of difficulty of endotracheal intubation with the Macintosh laryngoscope.

The variables which together are most reliable in predicting likely difficulty in intubation are reduced atlanto-occipital extension, reduced mandibular space, and lastly, increased antero-posterior thickness of the tongue.

Life-threatening airway obstruction as a complication to the management of mediastinal masses in children.

Managing the difficult airway in patients with burns of the head and neck.

A five-phase defined protocol for airway security was developed and administered to a consecutive, selected series of surgical patients with burns to the head and neck that limited their mouth

Routine Clinical Practice Effectiveness of the Glidescope in Difficult Airway Management: An Analysis of 2,004 Glidescope Intubations, Complications, and Failures from Two Institutions

A high success rate of Glidescope intubation in both primary airway management and rescue-failed direct laryngoscopy is demonstrated, however, it is not always successful and certain predictors of failure can be identified.

The UpsherScope[trademark symbol] in Routine and Difficult Airway Management: A Randomized, Controlled Clinical Trial

No advantage of the UpsherScope[trademark symbol] over direct laryngoscopy during routine and difficult airway management is found, and time needed, number of attempts required, and incidence of failure were significantly longer and higher in group US.