The unanticipated difficult airway — evolving strategies for successful salvage

Incomplete adherence to the ASA difficult airway algorithm is unchanged after a high-fidelity simulation session

“…[27][28][29] Due to the rarity of CICV situations, 30 experienced anesthesiologists may tend to assume that specific training on airway tools is unnecessary. 1,31 This behaviour, i.e., being excessively reliant on expertise, may well be extrapolated to other anesthesiologists. 1,22,31 As previously discussed, adults learn more when they willingly search for knowledge.…”

“…1,31 This behaviour, i.e., being excessively reliant on expertise, may well be extrapolated to other anesthesiologists. 1,22,31 As previously discussed, adults learn more when they willingly search for knowledge. 21 However, since consultant physicians tend to participate in meeting workshops where they are already knowledgeable about the topics being addressed 32 and since they often fail in their selfassessment of educational needs, 32,33 more effective approaches are needed to engage consultant anesthesiologists in maintaining excellence in the management of the emergency airway.…”

“…It is estimated that 100 to 700 real-life ''cannot intubate, cannot ventilate'' (CICV) events are managed in Canada every year. 1 Despite the publication of various practice guidelines for the management of CICV, [2][3][4] poor outcomes related to mismanagement of CICV situations, such as death and brain damage, still persist. [5][6][7][8][9][10] Situational stress, low familiarity with other techniques of tracheal intubation other than direct laryngoscopy, and lack of adherence to published emergency airway algorithms are thought to be important reasons for this reality.…”

“…[5][6][7][8][9][10] Situational stress, low familiarity with other techniques of tracheal intubation other than direct laryngoscopy, and lack of adherence to published emergency airway algorithms are thought to be important reasons for this reality. 1,3,7,8 Simulation has proven value in training management of emergency situations in anesthesia. 11,12 High-fidelity simulation reproduces the conditions under which lifesaving decisions need to be made, adding psychological stress and time pressure, factors known to affect performance.…”

Brief review: The Cobra Perilaryngeal Airway (CobraPLA®) and the Streamlined Liner of Pharyngeal Airway (SLIPA™) supraglottic airways

“…Accordingly, the LMA Classic™ has become, in recent years, both a primary airway and a rescue device in cannot intubate, cannot ventilate events. [1][2][3][4] Over the past decade, several new SGA devices have been introduced as alternatives to the LMA Classic™. 5 Several factors have stimulated the continuing development of supraglottic airways, in what has evolved into a highly competitive marketplace for the manufacturers of these devices.…”