This chapter explores the different techniques and challenges faced by emergency medical providers during pre-hospital airway management of critically ill patients. It is a crucial topic that has a major impact on patient’s safety. Improper airway management in this category of patients can lead to catastrophic results in terms of morbidity and mortality, this fact stimulates the ongoing improvement and evolution in this area of practice. We explore some of the debatable topics in pre-hospital airway management like airway management in the pediatric group, the use of medication assisted intubation and rapid sequence intubation in the field as well as the role of video assisted intubation and it’s challenges in the field. The up-to-date practices and research findings in the most recent related articles are discussed here in this chapter.

This topic aims to discuss key aspects of anesthetic and airway management for head and neck surgery. Airway management is a central part of patient care and management in Head and Neck Surgery. Common challenges in Head and Neck surgery are shared airway, distorted airway anatomy due to existing pathology; risk of airway obstruction, disconnection or loss of airway intra-operatively; risk of soiling of the airway due to bleeding and surgical debris; and the potential for airway compromise post-operatively. The option for airway management technique is influenced by patient’s factors, anesthetic needs, and surgical requirements. Intubation technique necessitating either a small or large cuffed tracheal tube with a throat pack provides the highest level of airway protection Non-intubation or open airway techniques involve mask ventilation, apneic techniques, and insufflation techniques, or the use of a laryngeal mask airway. Lastly, jet ventilation techniques may be conducted via a supraglottic, subglottic or transtracheal routes. It is essential to have clear airway management plans including rescue airway strategies that should be communicated with the surgeons and patients at the earliest opportunity.

Moyamoya disease is a rare, progressive cerebrovascular occlusive disease; characterized by narrowing of the distal internal carotid arteries and their branches. The incidence is high in East Asians and most commonly presents in the first and fourth decade of life. Its symptoms are headaches, seizures, transient neurological deficits, and cognitive decline. Medical management is based on treating the symptoms and includes antiplatelet and anti-seizure medications. Surgical revascularization is the mainstay of treatment. Unique pathophysiology of moyamoya disease necessitates neuro-anesthesiologists to formulate an individualized plan perioperatively. The overriding goal of perioperative anesthetic management of moyamoya disease is to ensure optimal cerebral perfusion and protection. Maintenance of normotension, normocarbia, normo-oxygenation, normothermia, and euvolemia is the cornerstone during the perioperative period. Perioperative adequate analgesia is crucial to prevent cerebral ischemia and allows close neurological monitoring. This chapter reviews perioperative anesthetic management of patients with moyamoya disease.

This article was migrated. The article was marked as recommended. Health care systems, as well as graduate medical education and training, have experienced unprecedented disruption due to the COVID-19 pandemic. Many academic medical institutions have adopted innovative strategies, technology, and dramatic transformation to continuously provide education and training to physicians in training while providing utmost and urgent care to the growing number of COVID-19 patients. Furthermore, medical societies have prioritized personal well-being, flexibility, and support for the trainees. Herein, we share the experience, lesson learned, practical guidance, and highlight the challenges faced by the program director and fellows of the advanced anesthesiology fellowship program at Hamad Medical Corporation.