Management of The Difficult Airway Part II: Proper Preparation for the Awake Intubation, Fiberoptic and Retrograde Techniques

  • J. L. Benumof
Part of the Developments in Critical Care Medicine and Anesthesiology book series (DCCA, volume 25)


If it is recognized that the EIT intubation or mask ventilation is going to be difficult due to the presence of an obvious factor(s) or a combination of subtle factors (large tongue size, small mandibular space, restricted atlanto-occipital extension), then airway patency should be secured and guaranteed (usually by EIT intubation) while the patient is awake. Although this is generally much more time consuming for the anesthesiologist and a more unpleasant experience for the patient compared to a routine intravenous anesthetic induction, there are several compelling reasons why ETT intubation should be done while a patient with a recognized difficult airway is still awake. First, and most importantly, gas exchange is better maintained in most patients (“no bridges are burned”); this is simply good common sense. Second, and one of the basic reasons why gas exchange is maintained in the awake patient, is that muscle tone is maintained which keeps the relevant upper airway structures separated from one another and much easier to identify.


Fiberoptic Bronchoscope Superior Laryngeal Nerve Awake Intubation Cricothyroid Membrane Fiberoptic Intubation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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© Springer Science+Business Media Dordrecht 1992

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  • J. L. Benumof

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