Management of the Difficult Airway Part III: The Anesthetized Patient whose Trachea is Difficult to Intubate, Transtracheal Jet Ventilation, the Difficult Extubation and Jet Stylets
There are four general situations in which an anesthesiologist will be required to intubate an unconscious or generally anesthetized patient who has a very difficult airway. First, the patient may already be unconscious (e.g., posttrauma) or generally anesthetized (e.g., drug overdose). Second, the patient may absolutely refuse to be intubated awake (e.g., an intoxicated combative patient). Third, and perhaps the largest category, the anesthesiologist failed to recognize intubation difficulty on the preoperative evaluation. Fourth, and perhaps a subset of number 2 above, pediatric patients older than several months usually require general anesthesia for EIT intubation irrespective of the findings on preoperative airway evaluation. Of course, even in situations 1, 2, and 4 above, the preoperative airway evaluation is very important because the findings may still dictate the choice of ETT intubation technique.
KeywordsDifficult Airway Anesthetize Patient Anesthesia Machine Tube Exchanger Corrugate Tubing
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