Management of the Difficult and Failed Airway

Orlando R. Hung, BSc (Pharmacy), MD, FRCP(C) Professor, Departments of Anesthesia, Surgery, and Pharmacology Director of Research, Department of Anesthesia, Dalhousie University Queen Elizabeth II Health Sciences Centre Halifax, Nova Scotia, Canada Michael F. Murphy, MD, FRCP(C) Professor and Chair of Anesthesiology Professor, Emergency Medicine Dalhousie University District Chief Anesthesiology Capital District Health Authority Queen Elizabeth II Health Sciences Centre Halifax, Nava Scotia, Canada

Section 1: Foundations of Difficult and Failed Airway Management

1.Airway Evaluation
Michael F. Murphy MD, FRCPC and D. John Doyle MD, PhD FRCPC

2.The Algorithms
Michael F. Murphy, MD FRCPC and Edward T. Crosby, MD FRCPC

3.Preparation for Awake Intubation
Ian R. Morris, BEng, MD, FRCPC, DABA, FACEP

4.The Pharmacology of Intubation
Ronald B. George, MD, Orlando Hung, MD FRCP(C) and Robert E. Schneider, MD

5.Aspiration: Risks and Prevention
Saul Pytka, MD FRCPC, Idena Carroll, CRNA MS, and Edward Crosby, MD FRCPC

Section 2: Devices and Techniques for the Difficult and Failed Airway Management

6.Airway Devices and Techniques
Michael F. Murphy, MD FRCPC and Orlando Hung, MD FRCPC

7.Direct Laryngoscopy and Oral Intubation of the Trachea
John J. Henderson

8.Flexible Fiberoptic Intubation
Ian R. Morris, BEng, MD, FRCPC, DABA, FACEP

9.Rigid and Semirigid Fiberoptic and Video Laryngoscopy and Intubation
Richard M. Cooper BSc, MSc MD FRCPC and J. Adam Law BSc, MD FRCPC

10.Blind Intubation Techniques
Chris C. Christodoulou MBChB, FRCPC and Orlando R. Hung MD, FRCPC

11.Extraglottic Devices for Ventilation and Oxygenation
Felice E. Agrò, MD, D. John Doyle, MD PhD FRCPC, Orlando R. Hung, MD FRCPC, Thomas J. Coonan, MD FRCPC, Rita Cataldo, MD, Benedetta Gallì, MD, and Serena Antonelli, MD

12.Surgical Airway
Gordon O. Launcelott MD, FRCPC and Liane B. Johnson MDCM, FRCSC

Section 3: Case Studies in Difficult and Failed Airway Management

A. Airways Cases in Prehospital Care

13.What is Unique About Airway Management in the Prehospital Setting?
David Petrie MD, FRCPC, John Tallon MD, FRCPC, and Michael F. Murphy MD, FRCPC

14.Airway Management of a Patient with Traumatic Brain Injury (TBI)
J. Adam Law, MD FRCPC, Edward T. Crosby, MD FRCPC, Andy Jagoda, MD FACEP

15.Airway Management of an Unconscious Patient who Remains Trapped Inside the Vehicle Following a Motor Vehicle Accident
Tom C. Phu, MD, Orlando R. Hung, MD, FRCPC, and Ronald D. Stewart, MD

16.Airway Management of a Motorcyclist with a Full Face Helmet Following an Accident
Mark P. Vu, MD, FRCPC and Orlando R. Hung, MD, FRCPC

17. Airway Management of a Morbidly Obese Patient Suffering from a Cardiac Arrest
Saul Pytka, MD FRCPC, Idena Carroll, CRNA MS

18. Airway Management with Blunt Anterior Neck Trauma
David A. Caro, MD, Steven A. Godwin, MD

B: Airway Cases in the Emergency Department

19.Airway Management in the Emergency Department
Michael F. Murphy, MD FRCPC, Ron M. Walls, MD

20.Patient with Deadly Asthma Requires Intubation
Kerry B. Broderick, MD, Richard D. Zane, MD

21.Patient in Cardiogenic Shock
Kerry B. Broderick, MD

22.Airway Management of a Patient with Cardiogenic Pulmonary Edema
Kirk J. MacQuarrie, MD FRCPC

23.Airway Management of a Patient with a Stab Wound to the Neck
Michael F. Murphy, MD FRCPC

24.Airway Management in the Patient with Burns to the Head, Neck, Upper Torso and the Airway
Robert J. Vissers, MD FRCPC FACEP

25.Airway Management in a Patient with Angioedema
Michael F. Murphy, MD FRCPC, Neilson J. McLean, MD

26.Airway Management for Blunt Facial Trauma
David A. Caro, MD, Aaron E. Bair, MD

27.Airway Management in a Patient with Retropharyngeal Abscess
Kirk J. MacQuarrie MD, FRCPC, David Kirkpatrick MD, FRCSC

C: Airway Cases in the Critical Care Unit

28.Airway Management in the Intensive Care Unit (ICU)
Stephen Beed MD, FRCPC DipABA Cert CCM

29.Management of Extubation of a Patient Following a Prolonged Period of Mechanical Ventilation
Richard M. Cooper BSc, MSc, MD FRCPC

30.Management of an Accidental Extubation in a Patient in a Halo Jacket
Michael Frass, MD, Michael F. Murphy, MD FRCPC

31.Management of a SARS Patient Admitted to the ICU with Impending Respiratory Failure and a Clinical Suspicion of Difficult Airway
David T. Wong, MD

32.Performing an Elective Percutaneous Dilational Tracheotomy in a Patient on Mechanical Ventilation
Angelina Guzzo, MDCM, PhD, Liane B. Johnson MDCM, FRCSC, Orlando R. Hung, MD, FRCPC

D: Airway Cases: Surgical Patients in the Operating Room

33.Uncooperative Down Syndrome Patient
Michael F. Murphy MD, FRCPC

34.Airway Management in the Operating Room of a Patient with a History of Oral and Cervical Radiation Therapy
Ian R. Morris, BEng, MD, FRCPC, FACEP

35.Intra-Operative Accidental Dislodgement of the Endotracheal Tube in a Patient in Prone Position
Dennis Drapeau, BSc MD FRCPC, Orlando Hung, MD FRCPC

36.Airway Management of Patients with a History of Difficult Intubation for a Peripheral Procedure
Lorraine J. Foley, MD

37.Airway Management of a Patient with an Unanticipated Difficult Laryngoscopy
John J. Henderson MB, ChB, FRCA

38.Airway Management of a Patient with Superior Vena Cava Obstruction Syndrome
Gordon O. Launcelott, MD FRCPC

39.Airway Management of a Patient with History of Difficult Airway who Refuses to have Awake Tracheal Intubation
Steven Abramson, MD, Kyle Friedman, MD, Carin Hagberg, MD

40.Airway Management in the Operating Room of a Morbidly Obese Patient in a "Can’t intubate, Can’t Ventilate" Situation
David T. Wong, MD FRCPC

E: Pediatric Airway Cases

41.Unique Airway Issues in the Pediatric Population
Robert C. Luten, MD, Niranjan "Tex" Kissoon, MD FRCPC FAAP FCCM FACPE, Stephen A. Godwin MD, Michael F. Murphy, MD FRCPC

42.Airway Management of a Child with Epiglottitis
Christian M. Soder, MD FRCPC

43.Management of 12 year-old Child with a Foreign Body in the Bronchus
Liane B. Johnson, MDCM FRCSC

44.Airway Management of a Newborn with a Tracheoesophageal Fistula (TEF)
Babu V. Koka, MD, Sabeena K. Chacko, MD

45.Airway Management in a One Year-Old with Pierre Robin Syndrome for Myringotomy and Tubes
Christian M. Soder, MD FRCPC

46.Airway Management of a Six Year Old with a History of Difficult Airway for Bilateral Inguinal Hernia Repair
David C. Abramson, MBChB FFA (SA)

47.Pediatric Patient with a Closed Head Injury
Robert C. Luten, MD, Niranjan "Tex" Kissoon, MD FRCPC FAAP FCCM FACPE, Michael F. Murphy, MD FRCPC

F: Obstetrical Airway Cases

48.What is Unique about the Obstetrical Airway?
Brian K. Ross PhD, MD

49.Airway Management of the Obstetrical Patient with an Anticipated Difficult Airway
Brian K. Ross, PhD, MD

50.Unanticipated Difficult Airway in an Obstetrical Patient Requiring an Emergency Cesarean Section
Adeyemi J. Olufolabi, MB BS DCH FRCA, Holly A. Muir, MD FRCPC

51.Airway Management in the Pregnant Trauma Victim
Adeyemi J. Olufolabi, MB BS DCH FRCA, Holly A. Muir, MD FRCPC

G: Airway Cases in Other Hospital Settings

52.Unique Challenges of Ectopic Airway Management
Michael F. Murphy, MD FRCPC

53.Management of the Patient with a Neck Hematoma
J. Adam Law, MD FRCPC

54.Respiratory Arrest in the Magnetic Resonance Imaging (MRI) Suite
D. John Doyle, MD, PhD, FRCPC

55.Postobstructive Pulmonary Edema (POPE)
Matthew G. Simms, MSc MD, J. Adam Law, MD FRCPC

Section 4: Practical Considerations in Difficult and Failed Airway Management

56.Difficult Airway Carts
Saul Pytka, MD FRCPC, Michael F. Murphy, MD FRCPC

57.Documentation of Difficult Airway
Lorraine J. Foley, MD

Answers

Index