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Difficult AirwaySociety 2015guidelines formanagement ofunanticipateddifficult intubationin adults C. FrerkV. MitchellAlistair F. McNarry2015 год

Difficult Airway Society 2015 guidelines for management of unanticipated difficult intubation in adults
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Аннотация: These guidelines provide a strategy to manage unanticipated difficulty with tracheal intubation. They are founded on published evidence. Where evidence is lacking, they have been directed by feedback from members of the Difficult Airway Society and based on expert opinion. These guidelines have been informed by advances in the understanding of crisis management; they emphasize the recognition and declaration of difficulty during airway management. A simplified, single algorithm now covers unanticipated difficulties in both routine intubation and rapid sequence induction. Planning for failed intubation should form part of the pre-induction briefing, particularly for urgent surgery. Emphasis is placed on assessment, preparation, positioning, preoxygenation, maintenance of oxygenation, and minimizing trauma from airway interventions. It is recommended that the number of airway interventions are limited, and blind techniques using a bougie or through supraglottic airway devices have been superseded by video- or fibre-optically guided intubation. If tracheal intubation fails, supraglottic airway devices are recommended to provide a route for oxygenation while reviewing how to proceed. Second-generation devices have advantages and are recommended. When both tracheal intubation and supraglottic airway device insertion have failed, waking the patient is the default option. If at this stage, face-mask oxygenation is impossible in the presence of muscle relaxation, cricothyroidotomy should follow immediately. Scalpel cricothyroidotomy is recommended as the preferred rescue technique and should be practised by all anaesthetists. The plans outlined are designed to be simple and easy to follow. They should be regularly rehearsed and made familiar to the whole theatre team.
Год издания: 2015
Авторы: C. Frerk, V. Mitchell, Alistair F. McNarry, C. Mendonca, R Bhagrath, Anita Patel, E. O’Sullivan, N.M. Woodall, Imran Ahmad
Издательство: Elsevier BV
Источник: British Journal of Anaesthesia
Ключевые слова: Airway Management and Intubation Techniques, Tracheal and airway disorders, Respiratory Support and Mechanisms
Другие ссылки: British Journal of Anaesthesia (PDF)
British Journal of Anaesthesia (HTML)
Europe PMC (PubMed Central) (PDF)
Europe PMC (PubMed Central) (HTML)
PubMed Central (HTML)
PubMed (HTML)