Equipment to Manage a Difficult Airway during Anaesthesia

Abstract

Airway complications are a leading cause of morbidity and mortality in anaesthesia 1. Effective management of a difficult airway requires the timely availability of suitable airway equipment. The Australian and New Zealand College of Anaesthetists has recently developed guidelines for the minimum set of equipment needed for the effective management of an unexpected difficult airway (TG4 [2010] www.anzca.edu.au/resources/professionaldocuments). TG4 [2010] is based on expert consensus, underpinned by wide consultation and an extensive review of the available evidence, which is summarised in a Background Paper (TG4 BP [2010] www.anzca.edu.au/ resources/professional-documents). TG4 [2010] will be reviewed at the end of one year and thereafter every five years or more frequently if necessary. The current paper is reproduced directly from the Background Paper (TG4 BP [2010]).

A framework for the management of the pediatric airway

“…Principles of standardization, redundancy, and safety cultures need to apply. Make and manufacturer are less relevant, but the equipment must be suitable for children and acceptable to the clinician in charge …”

“…Make and manufacturer are less relevant, but the equipment must be suitable for children and acceptable to the clinician in charge. [39][40][41] Individual departments need to decide on the best options based on their needs and affordability. It is essential that pediatric airway equipment is well maintained and that staff are trained regularly.…”

Obstetric Airway Management

“…36 This is further exaggerated by the cardiac demands of active labor, increased BMI, and presence of sepsis. 38 35,37 Local Environment Factors Factors such as isolation of the obstetric unit, lack of skilled anesthetic support, lack of airway equipment, lack of training, and lack of familiarity with equipment that is available undoubtedly increase the risk of difficulty when managing the airway.…”

Pediatric airway management: current practices and future directions

“…‘Evidence is still lacking to support the replacement of standard laryngoscopes with nonstandard devices for routine or difficult intubations, and the results of large multicentre clinical trials of new airway devices are required’ .…”