naa a22 4500 510744699 CHVBK 20180411092755.0 cr unu---uuuuu 180411e20131101xx s 000 0 eng 10.1007/s12630-013-0019-3 doi (NATIONALLICENCE)springer-10.1007/s12630-013-0019-3 The difficult airway with recommendations for management - Part 1 - Difficult tracheal intubation encountered in an unconscious/induced patient [Elektronische Daten] [J. Law, Natasha Broemling, Richard Cooper, Pierre Drolet, Laura Duggan, Donald Griesdale, Orlando Hung, Philip Jones, George Kovacs, Simon Massey, Ian Morris, Timothy Mullen, Michael Murphy, Roanne Preston, Viren Naik, Jeanette Scott, Shean Stacey, Timothy Turkstra, David Wong] Prise en charge des voies aériennes - 1re partie - Recommandations lorsque des difficultés sont constatées chez le patient inconscient/anesthésié Background: Previously active in the mid-1990s, the Canadian Airway Focus Group (CAFG) studied the unanticipated difficult airway and made recommendations on management in a 1998 publication. The CAFG has since reconvened to examine more recent scientific literature on airway management. The Focus Group's mandate for this article was to arrive at updated practice recommendations for management of the unconscious/induced patient in whom difficult or failed tracheal intubation is encountered. Methods: Nineteen clinicians with backgrounds in anesthesia, emergency medicine, and intensive care joined this iteration of the CAFG. Each member was assigned topics and conducted reviews of Medline, EMBASE, and Cochrane databases. Results were presented and discussed during multiple teleconferences and two face-to-face meetings. When appropriate, evidence- or consensus-based recommendations were made together with assigned levels of evidence modelled after previously published criteria. Conclusions: The clinician must be aware of the potential for harm to the patient that can occur with multiple attempts at tracheal intubation. This likelihood can be minimized by moving early from an unsuccessful primary intubation technique to an alternative "Plan B” technique if oxygenation by face mask or ventilation using a supraglottic device is non-problematic. Irrespective of the technique(s) used, failure to achieve successful tracheal intubation in a maximum of three attempts defines failed tracheal intubation and signals the need to engage an exit strategy. Failure to oxygenate by face mask or supraglottic device ventilation occurring in conjunction with failed tracheal intubation defines a failed oxygenation, "cannot intubate, cannot oxygenate” situation. Cricothyrotomy must then be undertaken without delay, although if not already tried, an expedited and concurrent attempt can be made to place a supraglottic device. The Author(s), 2013 Law J. Department of Anesthesia, Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax Infirmary Site, 1796 Summer Street, B3H 3A7, Halifax, NS, Canada aut Broemling Natasha aut Cooper Richard aut Drolet Pierre aut Duggan Laura aut Griesdale Donald aut Hung Orlando aut Jones Philip aut Kovacs George aut Massey Simon aut Morris Ian aut Mullen Timothy aut Murphy Michael aut Preston Roanne aut Naik Viren aut Scott Jeanette aut Stacey Shean aut Turkstra Timothy aut Wong David aut Canadian Journal of Anesthesia/Journal canadien d'anesthésie Springer US; http://www.springer-ny.com 60/11(2013-11-01), 1089-1118 0832-610X 60:11<1089 2013 60 12630 https://doi.org/10.1007/s12630-013-0019-3 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12630-013-0019-3 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Law J. Department of Anesthesia, Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax Infirmary Site, 1796 Summer Street, B3H 3A7, Halifax, NS, Canada aut NATIONALLICENCE 700 1- Broemling Natasha aut NATIONALLICENCE 700 1- Cooper Richard aut NATIONALLICENCE 700 1- Drolet Pierre aut NATIONALLICENCE 700 1- Duggan Laura aut NATIONALLICENCE 700 1- Griesdale Donald aut NATIONALLICENCE 700 1- Hung Orlando aut NATIONALLICENCE 700 1- Jones Philip aut NATIONALLICENCE 700 1- Kovacs George aut NATIONALLICENCE 700 1- Massey Simon aut NATIONALLICENCE 700 1- Morris Ian aut NATIONALLICENCE 700 1- Mullen Timothy aut NATIONALLICENCE 700 1- Murphy Michael aut NATIONALLICENCE 700 1- Preston Roanne aut NATIONALLICENCE 700 1- Naik Viren aut NATIONALLICENCE 700 1- Scott Jeanette aut NATIONALLICENCE 700 1- Stacey Shean aut NATIONALLICENCE 700 1- Turkstra Timothy aut NATIONALLICENCE 700 1- Wong David aut NATIONALLICENCE 773 0- Canadian Journal of Anesthesia/Journal canadien d'anesthésie Springer US; http://www.springer-ny.com 60/11(2013-11-01), 1089-1118 0832-610X 60:11<1089 2013 60 12630 Metadata rights reserved Springer special CC-BY-NC licence nationallicence SWISSBIB 510744699 BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer