Canadian Airway Focus Group updated consensus-based recommendations for management of the difficult airway: part 1. Difficult airway management encountered in an unconscious patient

J Adam Law, Laura V Duggan, Mathieu Asselin, Paul Baker, Edward Crosby, Andrew Downey, Orlando R Hung, Philip M Jones, François Lemay, Rudiger Noppens, Matteo Parotto, Roanne Preston, Nick Sowers, Kathryn Sparrow, Timothy P Turkstra, David T Wong, George Kovacs, Canadian Airway Focus Group, J Adam Law, Laura V Duggan, Mathieu Asselin, Paul Baker, Edward Crosby, Andrew Downey, Orlando R Hung, Philip M Jones, François Lemay, Rudiger Noppens, Matteo Parotto, Roanne Preston, Nick Sowers, Kathryn Sparrow, Timothy P Turkstra, David T Wong, George Kovacs, Canadian Airway Focus Group

Abstract

Purpose: Since the last Canadian Airway Focus Group (CAFG) guidelines were published in 2013, the literature on airway management has expanded substantially. The CAFG therefore re-convened to examine this literature and update practice recommendations. This first of two articles addresses difficulty encountered with airway management in an unconscious patient.

Source: Canadian Airway Focus Group members, including anesthesia, emergency medicine, and critical care physicians, were assigned topics to search. Searches were run in the Medline, EMBASE, Cochrane Central Register of Controlled Trials, and CINAHL databases. Results were presented to the group and discussed during video conferences every two weeks from April 2018 to July 2020. These CAFG recommendations are based on the best available published evidence. Where high-quality evidence was lacking, statements are based on group consensus.

Findings and key recommendations: Most studies comparing video laryngoscopy (VL) with direct laryngoscopy indicate a higher first attempt and overall success rate with VL, and lower complication rates. Thus, resources allowing, the CAFG now recommends use of VL with appropriately selected blade type to facilitate all tracheal intubations. If a first attempt at tracheal intubation or supraglottic airway (SGA) placement is unsuccessful, further attempts can be made as long as patient ventilation and oxygenation is maintained. Nevertheless, total attempts should be limited (to three or fewer) before declaring failure and pausing to consider "exit strategy" options. For failed intubation, exit strategy options in the still-oxygenated patient include awakening (if feasible), temporizing with an SGA, a single further attempt at tracheal intubation using a different technique, or front-of-neck airway access (FONA). Failure of tracheal intubation, face-mask ventilation, and SGA ventilation together with current or imminent hypoxemia defines a "cannot ventilate, cannot oxygenate" emergency. Neuromuscular blockade should be confirmed or established, and a single final attempt at face-mask ventilation, SGA placement, or tracheal intubation with hyper-angulated blade VL can be made, if it had not already been attempted. If ventilation remains impossible, emergency FONA should occur without delay using a scalpel-bougie-tube technique (in the adult patient). The CAFG recommends all institutions designate an individual as "airway lead" to help institute difficult airway protocols, ensure adequate training and equipment, and help with airway-related quality reviews.

Keywords: airway management; difficult; failed; guidelines; intubation; tracheal.

© 2021. The Author(s).

Figures

FIGURE
FIGURE
Flow diagram: difficult tracheal intubation encountered in the unconscious patient

References

    1. Joffe AM, Aziz MF, Posner KL, Duggan LV, Mincer SL, Domino KB. Management of difficult tracheal intubation: a closed claims analysis. Anesthesiology. 2019;131:818–829.
    1. Crosby ET, Duggan LV, Finestone PJ, Liu R, De Gorter R, Calder LA. Anesthesiology airway-related medicolegal cases from the Canadian Medical Protection Association. Can J Anesth. 2021;68:183–195.
    1. Cook T, Woodall N, Frerk C. 4th National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Major complications of airway management in the United Kingdom. London: The Royal College of Anaesthetists; 2011.
    1. Kluger MT, Culwick MD, Moore MR, Merry AF. Aspiration during anaesthesia in the first 4000 incidents reported to webAIRS. Anaesth Intensive Care. 2019;47:442–451.
    1. Crosby ET, Cooper RM, Douglas MJ, et al. The unanticipated difficult airway with recommendations for management. Can J Anaesth. 1998;45:757–776.
    1. Law JA, Broemling N, Cooper RM, et al. The difficult airway with recommendations for management–part 1–difficult tracheal intubation encountered in an unconscious/induced patient. Can J Anesth. 2013;60:1089–1118.
    1. Law JA, Broemling N, Cooper RM, et al. The difficult airway with recommendations for management–part 2–the anticipated difficult airway. Can J Anesth. 2013;60:1119–1138.
    1. Law JA, Duggan LV, Asselin M, et al. Canadian Airway Focus Group consensus-based recommendations for management of the difficult airway: part 2. Planning and implementing safe management of the patient with an anticipated difficult airway Can J Anesth. 2021 doi: 10.1007/s12630-021-02008-z.
    1. Frerk C, Mitchell VS, McNarry AF, et al. Difficult Airway Society 2015 guidelines for management of unanticipated difficult intubation in adults. Br J Anaesth. 2015;115:827–848.
    1. Higgs A, McGrath BA, Goddard C, et al. Guidelines for the management of tracheal intubation in critically ill adults. Br J Anaesth. 2018;120:323–352.
    1. Piepho T, Cavus E, Noppens R, et al. S1 guidelines on airway management: guideline of the German Society of Anesthesiology and Intensive Care Medicine. Anaesthesist. 2015;64(Suppl 1):27–40.
    1. Myatra SN, Shah A, Kundra P, et al. All India Difficult Airway Association 2016 guidelines for the management of unanticipated difficult tracheal intubation in adults. Indian J Anaesth. 2016;60:885–898.
    1. Cook TM. Strategies for the prevention of airway complications - a narrative review. Anaesthesia. 2018;73:93–111.
    1. Han R, Tremper KK, Kheterpal S, O’Reilly M. Grading scale for mask ventilation. Anesthesiology. 2004 doi: 10.1097/00000542-200407000-00059.
    1. Lim KS, Nielsen JR. Objective description of mask ventilation. Br J Anaesth. 2016;117:828–829.
    1. Cormack RS, Lehane J. Difficult tracheal intubation in obstetrics. Anaesthesia. 1984;39:1105–1111.
    1. Yentis SM, Lee DJ. Evaluation of an improved scoring system for the grading of direct laryngoscopy. Anaesthesia. 1998;53:1041–1044.
    1. Cook TM. A new practical classification of laryngeal view. Anaesthesia. 2000;55:274–279.
    1. Norskov AK, Wetterslev J, Rosenstock CV, et al. Prediction of difficult mask ventilation using a systematic assessment of risk factors vs. existing practice - a cluster randomised clinical trial in 94,006 patients. Anaesthesia 2017; 72: 296-308.
    1. Norskov AK, Rosenstock CV, Wetterslev J, Astrup G, Afshari A, Lundstrom LH. Diagnostic accuracy of anaesthesiologists’ prediction of difficult airway management in daily clinical practice: a cohort study of 188 064 patients registered in the Danish Anaesthesia Database. Anaesthesia. 2015;70:272–281.
    1. Kheterpal S, Han R, Tremper KK, et al. Incidence and predictors of difficult and impossible mask ventilation. Anesthesiology. 2006;105:885–891.
    1. Kheterpal S, Healy D, Aziz MF, et al. Incidence, predictors, and outcome of difficult mask ventilation combined with difficult laryngoscopy: a report from the multicenter perioperative outcomes group. Anesthesiology. 2013;119:1360–1369.
    1. Aziz MF, Kim D, Mako J, Hand K, Brambrink AM. A retrospective study of the performance of video laryngoscopy in an obstetric unit. Anesth Analg. 2012;115:904–906.
    1. Hawthorne L, Wilson R, Lyons G, Dresner M. Failed intubation revisited: 17-yr experience in a teaching maternity unit. Br J Anaesth. 1996;76:680–684.
    1. Valois-Gomez T, Oofuvong M, Auer G, Coffin D, Loetwiriyakul W, Correa JA. Incidence of difficult bag-mask ventilation in children: a prospective observational study. Paediatr Anaesth. 2013;23:920–926.
    1. Daigle CH, Fiadjoe JE, Laverriere EK, et al. Difficult bag-mask ventilation in critically ill children is independently associated with adverse events. Crit Care Med. 2020;48:e744–e752.
    1. Alkhouri H, Vassiliadis J, Murray M, et al. Emergency airway management in Australian and New Zealand emergency departments: a multicentre descriptive study of 3710 emergency intubations. Emerg Med Australas. 2017;29:499–508.
    1. De Jong A, Molinari N, Terzi N, et al. Early identification of patients at risk for difficult intubation in the intensive care unit: development and validation of the MACOCHA score in a multicenter cohort study. Am J Respir Crit Care Med. 2013;187:832–839.
    1. Kheterpal S, Martin L, Shanks AM, Tremper KK. Prediction and outcomes of impossible mask ventilation: a review of 50,000 anesthetics. Anesthesiology. 2009;110:891–897.
    1. Muller JU, Semmel T, Stepan R, et al. The use of the laryngeal tube disposable by paramedics during out-of-hospital cardiac arrest: a prospectively observational study (2008-2012) Emerg Med J. 2013;30:1012–1016.
    1. Jabre P, Penaloza A, Pinero D, et al. Effect of bag-mask ventilation vs endotracheal intubation during cardiopulmonary resuscitation on neurological outcome after out-of-hospital cardiorespiratory arrest: a randomized clinical trial. JAMA. 2018;319:779–787.
    1. Heinrich S, Birkholz T, Irouschek A, Ackermann A, Schmidt J. Incidences and predictors of difficult laryngoscopy in adult patients undergoing general anesthesia: a single-center analysis of 102,305 cases. J Anesth. 2013;27:815–821.
    1. De Jong A, Molinari N, Pouzeratte Y, et al. Difficult intubation in obese patients: incidence, risk factors, and complications in the operating theatre and in intensive care units. Br J Anaesth. 2015;114:297–306.
    1. Heinrich S, Irouschek A, Prottengeier J, Ackermann A, Schmidt J. Adverse airway events in parturient compared with non-parturient patients. Is there a difference? Results from a quality management project. J Obstet Gynaecol Res 2015; 41: 1032-9.
    1. Rajagopalan S, Suresh M, Clark SL, Serratos B, Chandrasekhar S. Airway management for cesarean delivery performed under general anesthesia. Int J Obstet Anesth. 2017;29:64–69.
    1. McKeen DM, George RB, O’Connell CM, et al. Difficult and failed intubation: incident rates and maternal, obstetrical, and anesthetic predictors. Can J Anesth. 2011;58:514–524.
    1. Odor PM, Bampoe S, Moonesinghe SR, et al. General anaesthetic and airway management practice for obstetric surgery in England: a prospective, multicentre observational study. Anaesthesia. 2021;76:460–471.
    1. Engelhardt T, Virag K, Veyckemans F, Habre W; APRICOT Group of the European Society of Anaesthesiology Clinical Trial Network. Airway management in paediatric anaesthesia in Europe-insights from APRICOT (Anaesthesia Practice In Children Observational Trial): a prospective multicentre observational study in 261 hospitals in Europe. Br J Anaesth 2018; 121: 66-75.
    1. Fiadjoe JE, Nishisaki A, Jagannathan N, et al. Airway management complications in children with difficult tracheal intubation from the Pediatric Difficult Intubation (PeDI) registry: a prospective cohort analysis. Lancet Respir Med. 2016;4:37–48.
    1. Driver BE, Prekker ME, Klein LR, et al. Effect of use of a bougie vs endotracheal tube and stylet on first-attempt intubation success among patients with difficult airways undergoing emergency intubation: a randomized clinical trial. JAMA. 2018;319:2179–2189.
    1. Sakles JC, Douglas MJ, Hypes CD, Patanwala AE, Mosier JM. Management of patients with predicted difficult airways in an academic emergency department. J Emerg Med. 2017;53:163–171.
    1. Goto Y, Goto T, Hagiwara Y, Tsugawa Y, et al. Techniques and outcomes of emergency airway management in Japan: an analysis of two multicentre prospective observational studies, 2010-2016. Resuscitation. 2017;114:14–20.
    1. Hasegawa K, Shigemitsu K, Hagiwara Y, et al. Association between repeated intubation attempts and adverse events in emergency departments: an analysis of a multicenter prospective observational study. Ann Emerg Med 2012; 60: 749-54.e2.
    1. Kerslake D, Oglesby AJ, Di Rollo N, et al. Tracheal intubation in an urban emergency department in Scotland: a prospective, observational study of 3738 intubations. Resuscitation. 2015;89:20–24.
    1. Heuer JF, Barwing TA, Barwing J, et al. Incidence of difficult intubation in intensive care patients: analysis of contributing factors. Anaesth Intensive Care. 2012;40:120–127.
    1. Smischney NJ, Seisa MO, Heise KJ, et al. Practice of intubation of the critically ill at Mayo Clinic. J Intensive Care Med. 2017 doi: 10.1177/0885066617691495.
    1. Semler MW, Janz DR, Russell DW, et al. A multicenter, randomized trial of ramped position vs sniffing position during endotracheal intubation of critically ill adults. Chest. 2017;152:712–722.
    1. Aziz MF, Brambrink AM, Healy DW, et al. Success of intubation rescue techniques after failed direct laryngoscopy in adults: a retrospective comparative analysis from the Multicenter Perioperative Outcomes Group. Anesthesiology. 2016;125:656–666.
    1. Schroeder RA, Pollard R, Dhakal I, et al. Temporal trends in difficult and failed tracheal intubation in a regional community anesthetic practice. Anesthesiology. 2018;128:502–510.
    1. Madsen MG, Lundstrom LH, Rosenstock CV. Failed intubation in obstetrics registered in the Danish anaesthesia database. Acta Anaesthesiol Scand 2013; 57: 36 (abstract).
    1. Kinsella SM, Winton AL, Mushambi MC, et al. Failed tracheal intubation during obstetric general anaesthesia: a literature review. Int J Obstet Anesth. 2015;24:356–374.
    1. Bhattacharjee S, Maitra S, Baidya DK. A comparison between video laryngoscopy and direct laryngoscopy for endotracheal intubation in the emergency department: a meta-analysis of randomized controlled trials. J Clin Anesth. 2018;47:21–26.
    1. Lockey D, Crewdson K, Weaver A, Davies G. Observational study of the success rates of intubation and failed intubation airway rescue techniques in 7256 attempted intubations of trauma patients by pre-hospital physicians. Br J Anaesth. 2014;113:220–225.
    1. Park L, Zeng I, Brainard A. Systematic review and meta-analysis of first-pass success rates in emergency department intubation: creating a benchmark for emergency airway care. Emerg Med Australas. 2017;29:40–47.
    1. Pallin DJ, Dwyer RC, Walls RM, Brown CA 3rd; NEAR III Investigators. Techniques and trends, success rates, and adverse events in emergency department pediatric intubations: a report from the National Emergency Airway Registry. Ann Emerg Med 2016; 67: 610-15.e1.
    1. Ono Y, Kakamu T, Kikuchi H, Mori Y, Watanabe Y, Shinohara K. Expert-performed endotracheal intubation-related complications in trauma patients: incidence, possible risk factors, and outcomes in the prehospital setting and emergency department. Emerg Med Int. 2018 doi: 10.1155/2018/5649476.
    1. Ramachandran SK, Mathis MR, Tremper KK, Shanks AM, Kheterpal S. Predictors and clinical outcomes from failed laryngeal mask airway Unique™: a study of 15,795 patients. Anesthesiology. 2012;116:1217–1226.
    1. Geng ZY, Wang DX. Laryngeal mask airway for cesarean delivery: a 5-year retrospective cohort study. Chin Med J (Engl) 2017;130:404–408.
    1. Yao WY, Li SY, Yuan YJ, et al. Comparison of Supreme laryngeal mask airway versus endotracheal intubation for airway management during general anesthesia for cesarean section: a randomized controlled trial. BMC Anesthesiol. 2019 doi: 10.1186/s12871-019-0792-9.
    1. Li SY, Yao WY, Yuan YJ, et al. Supreme™ laryngeal mask airway use in general anesthesia for category 2 and 3 cesarean delivery: a prospective cohort study. BMC Anesthesiol. 2017 doi: 10.1186/s12871-017-0460-x.
    1. St. Clair Logan A, Morris P. Complications following use of the laryngeal mask airway in children. Paediatr Anaesth 1993; 3: 297-300.
    1. Gahan K, Studnek JR, Vandeventer S. King LT-D use by urban basic life support first responders as the primary airway device for out-of-hospital cardiac arrest. Resuscitation. 2011;82:1525–1528.
    1. Saito T, Liu W, Chew ST, Ti LK. Incidence of and risk factors for difficult ventilation via a supraglottic airway device in a population of 14,480 patients from South-East Asia. Anaesthesia. 2015;70:1079–1083.
    1. Mathis MR, Haydar B, Taylor EL, et al. Failure of the laryngeal mask airway Unique™ and Classic™ in the pediatric surgical patient: a study of clinical predictors and outcomes. Anesthesiology. 2013;119:1284–1295.
    1. Benger JR, Kirby K, Black S, et al. Effect of a strategy of a supraglottic airway device vs tracheal intubation during out-of-hospital cardiac arrest on functional outcome: the AIRWAYS-2 randomized clinical trial. JAMA. 2018;320:779–791.
    1. Diggs LA, Yusuf JE, De Leo G. An update on out-of-hospital airway management practices in the United States. Resuscitation. 2014;85:885–892.
    1. Bernhard M, Gries A, Ramshorn-Zimmer A, Wenzel V, Hossfeld B. Insertion success of the laryngeal tube in emergency airway management. Biomed Res Int. 2016 doi: 10.1155/2016/3619159.
    1. Rosenstock CV, Norskov AK, Wetterslev J, Lundstrom LH; Danish Anaesthesia Database. Emergency surgical airway management in Denmark: a cohort study of 452 461 patients registered in the Danish Anaesthesia Database. Br J Anaesth 2016; 117 Suppl 1: i75-82.
    1. Kwon YS, Lee CA, Park S, Ha SO, Sim YS, Baek MS. Incidence and outcomes of cricothyrotomy in the “cannot intubate, cannot oxygenate” situation. Medicine (Baltimore) 2019 doi: 10.1097/MD.0000000000017713.
    1. Peters J, Bruijstens L, van der Ploeg J, Tan E, Hoogerwerf N, Edwards M. Indications and results of emergency surgical airways performed by a physician-staffed helicopter emergency service. Injury. 2015;46:787–790.
    1. Japanese Society of Anesthesiologists JSA airway management guideline 2014: to improve the safety of induction of anesthesia. J Anesth. 2014;28:482–493.
    1. Fei M, Blair JL, Rice MJ, et al. Comparison of effectiveness of two commonly used two-handed mask ventilation techniques on unconscious apnoeic obese adults. Br J Anaesth. 2017;118:618–624.
    1. Sato S, Hasegawa M, Okuyama M, et al. Mask ventilation during induction of general anesthesia: influences of obstructive sleep apnea. Anesthesiology. 2017;126:28–38.
    1. Joffe AM, Hetzel S, Liew EC. A two-handed jaw-thrust technique is superior to the one-handed “EC-clamp” technique for mask ventilation in the apneic unconscious person. Anesthesiology. 2010;113:873–879.
    1. Bouvet L, Albert ML, Augris C, et al. Real-time detection of gastric insufflation related to facemask pressure-controlled ventilation using ultrasonography of the antrum and epigastric auscultation in nonparalyzed patients: a prospective, randomized, double-blind study. Anesthesiology. 2014;120:326–334.
    1. Gerstein NS, Carey MC, Braude DA, et al. Efficacy of facemask ventilation techniques in novice providers. J Clin Anesth. 2013;25:193–197.
    1. Warters RD, Szabo TA, Spinale FG, DeSantis SM, Reves JG. The effect of neuromuscular blockade on mask ventilation. Anaesthesia. 2011;66:163–167.
    1. Itagaki T, Oto J, Burns SM, Jiang Y, Kacmarek RM, Mountjoy JR. The effect of head rotation on efficiency of face mask ventilation in anaesthetised apnoeic adults: a randomised, crossover study. Eur J Anaesthesiol. 2017;34:432–440.
    1. Joshi S, Prakash S, Mullick P, Usha G, Pawar M. Clinical evaluation of the cricoid pressure effect on bag mask ventilation, Proseal laryngeal mask airway placement and ventilation. Turk J Anaesthesiol Reanim. 2018;46:381–387.
    1. Gruber E, Oberhammer R, Balkenhol K, et al. Basic life support trained nurses ventilate more efficiently with laryngeal mask supreme than with facemask or laryngeal tube suction-disposable–a prospective, randomized clinical trial. Resuscitation. 2014;85:499–502.
    1. Cook TM, Kelly FE. Time to abandon the ‘vintage’ laryngeal mask airway and adopt second-generation supraglottic airway devices as first choice. Br J Anaesth. 2015;115:497–499.
    1. Intersurgical. User guide: i-gel® single use supraglottic airway. Available from URL: (accessed March 2021).
    1. The Laryngeal Mask Company Limited. Instructions for use - LMA Classic Excel™. Available from URL: (accessed March 2021).
    1. Dhulkhed PV, Khyadi SV, Jamale PB, Dhulkhed VK. A prospective randomised clinical trial for the comparison of two techniques for the insertion of Proseal laryngeal mask airway in adults-index finger insertion technique versus 90° rotation technique. Turk J Anaesthesiol Reanim. 2017;45:98–102.
    1. Park JH, Lee JS, Nam SB, Ju JW, Kim MS. Standard versus rotation technique for insertion of supraglottic airway devices: systematic review and meta-analysis. Yonsei Med J. 2016;57:987–997.
    1. Yun MJ, Hwang JW, Park SH, et al. The 90° rotation technique improves the ease of insertion of the ProSeal™ laryngeal mask airway in children. Can J Anesth. 2011;58:379–383.
    1. Jeon YT, Na HS, Park SH, et al. Insertion of the ProSeal laryngeal mask airway is more successful with the 90° rotation technique. Can J Anesth. 2010;57:211–215.
    1. Vannucci A, Rossi IT, Prifti K, et al. Modifiable and nonmodifiable factors associated with perioperative failure of extraglottic airway devices. Anesth Analg. 2018;126:1959–1967.
    1. Van Zundert AA, Gatt SP, Kumar CM, Van Zundert TC. Vision-guided placement of supraglottic airway device prevents airway obstruction: a prospective audit. Br J Anaesth. 2017;118:462–463.
    1. Van Zundert AA, Kumar CM, Van Zundert TC. Malpositioning of supraglottic airway devices: preventive and corrective strategies. Br J Anaesth. 2016;116:579–582.
    1. Li CW, Xue FS, Xu YC, et al. Cricoid pressure impedes insertion of, and ventilation through, the ProSeal laryngeal mask airway in anesthetized, paralyzed patients. Anesth Analg. 2007;104:1195–1198.
    1. Asai T, Goy RW, Liu EH. Cricoid pressure prevents placement of the laryngeal tube and laryngeal tube-suction II. Br J Anaesth. 2007;99:282–285.
    1. Hashimoto Y, Asai T, Arai T, Okuda Y. Effect of cricoid pressure on placement of the I-gel™: a randomised study. Anaesthesia. 2014;69:878–882.
    1. Aghamohammadi D, Eydi M, Hosseinzadeh H, Amiri Rahimi M, Golzari SE. Assessment of mini-dose succinylcholine effect on facilitatinglaryngeal mask airway insertion. J Cardiovasc Thorac Res. 2013;5:17–21.
    1. Na HS, Jeon YT, Shin HJ, Oh AY, Park HP, Hwang JW. Effect of paralysis at the time of ProSeal laryngeal mask airway insertion on pharyngolaryngeal morbidities. A randomized trial. PLoS One. 2015 doi: 10.1371/journal.pone.0134130.
    1. Hattori K, Komasawa N, Miyazaki Y, Kido H, Deguchi S, Minami T. Muscle relaxant facilitates i-gel insertion by novice doctors: a prospective randomized controlled trial. J Clin Anesth. 2016;33:218–222.
    1. Fujiwara A, Komasawa N, Nishihara I, et al. Muscle relaxant effects on insertion efficacy of the laryngeal mask ProSeal((R)) in anesthetized patients: a prospective randomized controlled trial. J Anesth. 2015;29:580–584.
    1. Kim GW, Kim JY, Kim SJ, Moon YR, Park EJ, Park SY. Conditions for laryngeal mask airway placement in terms of oropharyngeal leak pressure: a comparison between blind insertion and laryngoscope-guided insertion. BMC Anesthesiol. 2019 doi: 10.1186/s12871-018-0674-6.
    1. van Zundert AA, Wyssusek KH, Pelecanos A, Roets M, Kumar CM. A prospective randomized comparison of airway seal using the novel vision-guided insertion of LMA-Supreme(R) and LMA-Protector(R) J Clin Monit Comput. 2020;34:285–294.
    1. Choo CY, Koay CK, Yoong CS. A randomised controlled trial comparing two insertion techniques for the Laryngeal Mask Airway Flexible™ in patients undergoing dental surgery. Anaesthesia. 2012;67:986–990.
    1. Ozgul U, Erdil FA, Erdogan MA, et al. Comparison of videolaryngoscope-guided versus standard digital insertion techniques of the ProSeal™ laryngeal mask airway: a prospective randomized study. BMC Anesthesiol. 2019 doi: 10.1186/s12871-019-0915-3.
    1. Miyazaki Y, Komasawa N, Matsunami S, Kusaka Y, Minami T. Laryngoscopy facilitates successful i-gel insertion by novice doctors: a prospective randomized controlled trial. J Anesth. 2015;29:654–659.
    1. Taneja S, Agarwalt M, Dali JS, Agrawal G. Ease of Proseal laryngeal mask airway insertion and its fibreoptic view after placement using gum elastic bougie: a comparison with conventional techniques. Anaesth Intensive Care. 2009;37:435–440.
    1. Joffe AM, Schroeder KM, Shepler JA, Galgon RE. Validation of the unassisted, gum-elastic bougie-guided, laryngeal mask airway-ProSeal™ placement technique in anaesthetized patients. Indian J Anaesth. 2012;56:255–258.
    1. Aziz MF, Dillman D, Fu R, Brambrink AM. Comparative effectiveness of the C-MAC video laryngoscope versus direct laryngoscopy in the setting of the predicted difficult airway. Anesthesiology. 2012;116:629–636.
    1. Piepho T, Fortmueller K, Heid FM, Schmidtmann I, Werner C, Noppens RR. Performance of the C-MAC video laryngoscope in patients after a limited glottic view using Macintosh laryngoscopy. Anaesthesia. 2011;66:1101–1105.
    1. Gaszynski T. Clinical experience with the C-Mac videolaryngoscope in morbidly obese patients. Anaesthesiol Intensive Ther. 2014;46:14–16.
    1. Kaplan MB, Hagberg CA, Ward DS, et al. Comparison of direct and video-assisted views of the larynx during routine intubation. J Clin Anesth. 2006;18:357–362.
    1. Byhahn C, Iber T, Zacharowski K, et al. Tracheal intubation using the mobile C-MAC video laryngoscope or direct laryngoscopy for patients with a simulated difficult airway. Minerva Anestesiol. 2010;76:577–583.
    1. Raimann FJ, Dietze PE, Cuca CE, et al. Prospective trial to compare direct and indirect laryngoscopy using C-MAC PM(R) with Macintosh Blade and D-Blade(R) in a simulated difficult airway. Emerg Med Int. 2019 doi: 10.1155/2019/1067473.
    1. Hossfeld B, Frey K, Doerges V, Lampl L, Helm M. Improvement in glottic visualisation by using the C-MAC PM video laryngoscope as a first-line device for out-of-hospital emergency tracheal intubation: an observational study. Eur J Anaesthesiol. 2015;32:425–431.
    1. Malpas G, Kovacs G, Mackinnon SP, Hung O, Phipps S, Law JA. The videoscopic view may not be significantly superior to the directly sighted peroral view during Macintosh-style videolaryngoscopy: a randomized equivalence cadaver trial. Can J Anesth. 2020;67:827–835.
    1. Brown CA, 3rd, Kaji AH, Fantegrossi A, et al. Video laryngoscopy compared to augmented direct laryngoscopy in adult emergency department tracheal intubations: a National Emergency Airway Registry (NEAR) Study. Acad Emerg Med. 2020 doi: 10.1111/acem.13851.
    1. Sakles JC, Mosier J, Chiu S, Cosentino M, Kalin L. A comparison of the C-MAC video laryngoscope to the Macintosh direct laryngoscope for intubation in the emergency department. Ann Emerg Med. 2012;60:739–748.
    1. Yi IK, Kwak HJ, Kim KM, Ahn SH, Lee SY, Kim JY. Comparison of Pentax Airway Scope and Macintosh laryngoscope for orotracheal intubation in children: a randomised non-inferiority trial. Acta Anaesthesiol Scand. 2019;63:853–858.
    1. Serocki G, Neumann T, Scharf E, Dorges V, Cavus E. Indirect videolaryngoscopy with C-MAC D-Blade and GlideScope: a randomized, controlled comparison in patients with suspected difficult airways. Minerva Anestesiol. 2013;79:121–129.
    1. Serocki G, Bein B, Scholz J, Dorges V. Management of the predicted difficult airway: a comparison of conventional blade laryngoscopy with video-assisted blade laryngoscopy and the GlideScope. Eur J Anaesthesiol. 2010;27:24–30.
    1. Turkstra TP, Harle CC, Armstrong KP, et al. The GlideScope-specific rigid stylet and standard malleable stylet are equally effective for GlideScope use. Can J Anesth. 2007;54:891–896.
    1. Hoshijima H, Mihara T, Maruyama K, et al. McGrath videolaryngoscope versus Macintosh laryngoscope for tracheal intubation: a systematic review and meta-analysis with trial sequential analysis. J Clin Anesth. 2018;46:25–32.
    1. Abdelgadir IS, Phillips RS, Singh D, Moncreiff MP, Lumsden JL. Videolaryngoscopy versus direct laryngoscopy for tracheal intubation in children (excluding neonates) Cochrane Database Syst Rev. 2017 doi: 10.1002/14651858.CD011413.pub2.
    1. Cooper RM, Pacey JA, Bishop MJ, McCluskey SA. Early clinical experience with a new videolaryngoscope (GlideScope) in 728 patients. Can J Anesth. 2005;52:191–198.
    1. Aziz MF, Healy D, Kheterpal S, Fu RF, Dillman D, Brambrink AM. Routine clinical practice effectiveness of the Glidescope in difficult airway management: an analysis of 2,004 Glidescope intubations, complications, and failures from two institutions. Anesthesiology. 2011;114:34–41.
    1. Greer D, Marshall KE, Bevans S, Standlee A, McAdams P, Harsha W. Review of videolaryngoscopy pharyngeal wall injuries. Laryngoscope. 2017;127:349–353.
    1. Pham Q, Lentner M, Hu A. Soft palate injuries during orotracheal intubation with the videolaryngoscope. Ann Otol Rhinol Laryngol. 2017;126:132–137.
    1. De Jong A, Pouzeratte Y, Laplace A, et al. Macintosh videolaryngoscope for intubation in the operating room: a comparative quality improvement project. Anesth Analg. 2021;132:524–535.
    1. Gudivada KK, Jonnavithula N, Pasupuleti SL, Apparasu CP, Ayya SS, Ramachandran G. Comparison of ease of intubation in sniffing position and further neck flexion. J Anaesthesiol Clin Pharmacol. 2017;33:342–347.
    1. Lebowitz PW, Shay H, Straker T, Rubin D, Bodner S. Shoulder and head elevation improves laryngoscopic view for tracheal intubation in nonobese as well as obese individuals. J Clin Anesth. 2012;24:104–108.
    1. El-Orbany MI, Getachew YB, Joseph NJ, Salem MR, Friedman M. Head elevation improves laryngeal exposure with direct laryngoscopy. J Clin Anesth. 2015;27:153–158.
    1. Akihisa Y, Hoshijima H, Maruyama K, Koyama Y, Andoh T. Effects of sniffing position for tracheal intubation: a meta-analysis of randomized controlled trials. Am J Emerg Med. 2015;33:1606–1611.
    1. Levitan RM, Kinkle WC, Levin WJ, Everett WW. Laryngeal view during laryngoscopy: a randomized trial comparing cricoid pressure, backward-upward-rightward pressure, and bimanual laryngoscopy. Ann Emerg Med. 2006;47:548–555.
    1. Amathieu R, Combes X, Abdi W, et al. An algorithm for difficult airway management, modified for modern optical devices (Airtraq laryngoscope; LMA CTrach™): a 2-year prospective validation in patients for elective abdominal, gynecologic, and thyroid surgery. Anesthesiology. 2011;114:25–33.
    1. Gu Y, Robert J, Kovacs G, et al. A deliberately restricted laryngeal view with the GlideScope® video laryngoscope is associated with faster and easier tracheal intubation when compared with a full glottic view: a randomized clinical trial. Can J Anesth. 2016;63:928–937.
    1. Dupanovic M, Isaacson SA, Borovcanin Z, et al. Clinical comparison of two stylet angles for orotracheal intubation with the GlideScope video laryngoscope. J Clin Anesth. 2010;22:352–359.
    1. Jones PM, Turkstra TP, Armstrong KP, et al. Effect of stylet angulation and endotracheal tube camber on time to intubation with the GlideScope. Can J Anesth. 2007;54:21–27.
    1. Reynolds EC, Crowther N, Corbett L, et al. Improving laryngoscopy technique and success with the C-MAC(R) D blade: development and dissemination of the ‘Bath C-MAC D blade guide’. Br J Anaesth. 2020;125:e162–e164.
    1. Turkstra TP, Cusano F, Fridfinnson JA, Batohi P, Rachinsky M. Early endotracheal tube insertion with the GlideScope: a randomized controlled trial. Anesth Analg. 2016;122:753–757.
    1. Turkstra TP, Turkstra DC, Pavlosky AW, Jones PM. Simultaneous en bloc endotracheal tube insertion with GlideScope® Titanium™ video laryngoscope use: a randomized-controlled trial. Can J Anesth. 2020;67:1515–1523.
    1. Arima T, Nagata O, Miura T, et al. Comparative analysis of airway scope and Macintosh laryngoscope for intubation primarily for cardiac arrest in prehospital setting. Am J Emerg Med. 2014;32:40–43.
    1. Aziz MF, Abrons RO, Cattano D, et al. First-attempt intubation success of video laryngoscopy in patients with anticipated difficult direct laryngoscopy: a multicenter randomized controlled trial comparing the C-MAC D-Blade versus the GlideScope in a mixed provider and diverse patient population. Anesth Analg. 2016;122:740–750.
    1. Dhonneur G, Abdi W, Amathieu R, Ndoko S, Tual L. Optimising tracheal intubation success rate using the Airtraq laryngoscope. Anaesthesia. 2009;64:315–319.
    1. Downey A, Duggan LV, Law JA. A systematic review of meta-analyses comparing direct laryngoscopy with videolaryngscopy. Can J Anesth. 2021 doi: 10.1007/s12630-021-01921-7.
    1. Kaji AH, Shover C, Lee J, et al. Video versus direct and augmented direct laryngoscopy in pediatric tracheal intubations. Acad Emerg Med. 2020;27:394–402.
    1. Hoshijima H, Denawa Y, Tominaga A, Nakamura C, Shiga T, Nagasaka H. Videolaryngoscope versus Macintosh laryngoscope for tracheal intubation in adults with obesity: a systematic review and meta-analysis. J Clin Anesth. 2018;44:69–75.
    1. Hypes CD, Stolz U, Sakles JC, et al. Video laryngoscopy improves odds of first-attempt success at intubation in the intensive care unit. A propensity-matched analysis. Ann Am Thorac Soc 2016; 13: 382-90.
    1. Silverberg MJ, Li N, Acquah SO, Kory PD. Comparison of video laryngoscopy versus direct laryngoscopy during urgent endotracheal intubation: a randomized controlled trial. Crit Care Med. 2015;43:636–641.
    1. De Jong A, Molinari N, Conseil M, et al. Video laryngoscopy versus direct laryngoscopy for orotracheal intubation in the intensive care unit: a systematic review and meta-analysis. Intensive Care Med. 2014;40:629–639.
    1. Mosier JM, Whitmore SP, Bloom JW, et al. Video laryngoscopy improves intubation success and reduces esophageal intubations compared to direct laryngoscopy in the medical intensive care unit. Crit Care. 2013 doi: 10.1186/cc13061.
    1. Lingappan K, Arnold JL, Fernandes CJ, Pammi M. Videolaryngoscopy versus direct laryngoscopy for tracheal intubation in neonates. Cochrane Database Syst Rev. 2018 doi: 10.1002/14651858.CD009975.pub3.
    1. Kleine-Brueggeney M, Buttenberg M, Greif R, Nabecker S, Theiler L. Evaluation of three unchannelled videolaryngoscopes and the Macintosh laryngoscope in patients with a simulated difficult airway: a randomised, controlled trial. Anaesthesia. 2017;72:370–378.
    1. Pieters BM, Maas EH, Knape JT, van Zundert AA. Videolaryngoscopy vs. direct laryngoscopy use by experienced anaesthetists in patients with known difficult airways: a systematic review and meta-analysis. Anaesthesia 2017; 72: 1532-41.
    1. Lewis SR, Butler AR, Parker J, Cook TM, Smith AF. Videolaryngoscopy versus direct laryngoscopy for adult patients requiring tracheal intubation. Cochrane Database Syst Rev. 2016 doi: 10.1002/14651858.CD011136.pub2.
    1. Sakles JC, Patanwala AE, Mosier JM, Dicken JM. Comparison of video laryngoscopy to direct laryngoscopy for intubation of patients with difficult airway characteristics in the emergency department. Intern Emerg Med. 2014;9:93–98.
    1. Mosier JM, Stolz U, Chiu S, Sakles JC. Difficult airway management in the emergency department: GlideScope videolaryngoscopy compared to direct laryngoscopy. J Emerg Med. 2012;42:629–634.
    1. Sakles JC, Mosier JM, Patanwala AE, Dicken JM, Kalin L, Javedani PP. The C-MAC(R) video laryngoscope is superior to the direct laryngoscope for the rescue of failed first-attempt intubations in the emergency department. J Emerg Med 2015; 48: 280-6.
    1. Park R, Peyton JM, Fiadjoe JE, et al. The efficacy of GlideScope(R) videolaryngoscopy compared with direct laryngoscopy in children who are difficult to intubate: an analysis from the paediatric difficult intubation registry. Br J Anaesth. 2017;119:984–992.
    1. Jiang J, Ma D, Li B, Yue Y, Xue F. Video laryngoscopy does not improve the intubation outcomes in emergency and critical patients - a systematic review and meta-analysis of randomized controlled trials. Crit Care. 2017 doi: 10.1186/s13054-017-1885-9.
    1. Arulkumaran N, Lowe J, Ions R, Mendoza M, Bennett V, Dunser MW. Videolaryngoscopy versus direct laryngoscopy for emergency orotracheal intubation outside the operating room: a systematic review and meta-analysis. Br J Anaesth. 2018;120:712–724.
    1. Lakticova V, Koenig SJ, Narasimhan M, Mayo PH. Video laryngoscopy is associated with increased first pass success and decreased rate of esophageal intubations during urgent endotracheal intubation in a medical intensive care unit when compared to direct laryngoscopy. J Intensive Care Med. 2015;30:44–48.
    1. Eisenberg MA, Green-Hopkins I, Werner H, Nagler J. Comparison between direct and video-assisted laryngoscopy for intubations in a pediatric emergency department. Acad Emerg Med. 2016;23:870–877.
    1. Saposnik G, Redelmeier D, Ruff CC, Tobler PN. Cognitive biases associated with medical decisions: a systematic review. BMC Med Inform Decis Mak. 2016 doi: 10.1186/s12911-016-0377-1.
    1. Carayon P, Wood KE. Patient safety - the role of human factors and systems engineering. Stud Health Technol Inform. 2010;153:23–46.
    1. Rognas L, Hansen TM, Kirkegaard H, Tonnesen E. Pre-hospital advanced airway management by experienced anaesthesiologists: a prospective descriptive study. Scand J Trauma Resusc Emerg Med. 2013 doi: 10.1186/1757-7241-21-58.
    1. Kim J, Kim K, Kim T, et al. The clinical significance of a failed initial intubation attempt during emergency department resuscitation of out-of-hospital cardiac arrest patients. Resuscitation. 2014;85:623–627.
    1. Sauer CW, Kong JY, Vaucher YE, et al. Intubation attempts increase the risk for severe intraventricular hemorrhage in preterm infants-a retrospective cohort study. J Pediatr. 2016;177:108–113.
    1. Lee JH, Turner DA, Kamat P, et al. The number of tracheal intubation attempts matters! A prospective multi-institutional pediatric observational study. BMC Pediatr. 2016 doi: 10.1186/s12887-016-0593-y.
    1. Stinson HR, Srinivasan V, Topjian AA, et al. Failure of invasive airway placement on the first attempt is associated with progression to cardiac arrest in pediatric acute respiratory compromise. Pediatr Crit Care Med. 2018;19:9–16.
    1. Mort TC. Emergency tracheal intubation: complications associated with repeated laryngoscopic attempts. Anesth Analg. 2004;99:607–613.
    1. Griesdale DE, Bosma TL, Kurth T, Isac G, Chittock DR. Complications of endotracheal intubation in the critically ill. Intensive Care Med. 2008;34:1835–1842.
    1. Martin LD, Mhyre JM, Shanks AM, Tremper KK, Kheterpal S. 3,423 emergency tracheal intubations at a university hospital: airway outcomes and complications. Anesthesiology. 2011;114:42–48.
    1. Sakles JC, Chiu S, Mosier J, Walker C, Stolz U. The importance of first pass success when performing orotracheal intubation in the emergency department. Acad Emerg Med. 2013;20:71–78.
    1. Goto T, Watase H, Morita H, et al. Repeated attempts at tracheal intubation by a single intubator associated with decreased success rates in emergency departments: an analysis of a multicentre prospective observational study. Emerg Med J. 2015;32:781–786.
    1. Bodily JB, Webb HR, Weiss SJ, Braude DA. Incidence and duration of continuously measured oxygen desaturation during emergency department intubation. Ann Emerg Med. 2016;67:389–395.
    1. Apfelbaum JL, Hagberg CA, Caplan RA, et al. Practice guidelines for management of the difficult airway: an updated report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway. Anesthesiology. 2013;118:251–270.
    1. Petrini F, Accorsi A, Adrario E, et al. Recommendations for airway control and difficult airway management. Minerva Anestesiol. 2005;71:617–657.
    1. Petrini F, Di Giacinto I, Cataldo R, et al. Perioperative and periprocedural airway management and respiratory safety for the obese patient: 2016 SIAARTI Consensus. Minerva Anestesiol. 2016;82:1314–1335.
    1. Rehn M, Hyldmo PK, Magnusson V, et al. Scandinavian SSAI clinical practice guideline on pre-hospital airway management. Acta Anaesthesiol Scand. 2016;60:852–864.
    1. Myatra SN, Ahmed SM, Kundra P, et al. The All India Difficult Airway Association 2016 guidelines for tracheal intubation in the Intensive Care Unit. Indian J Anaesth. 2016;60:922–930.
    1. Sun F, Wang Y, Ma S, et al. Clinical consensus of emergency airway management. J Thorac Dis. 2017;9:4599–4606.
    1. Australian and New Zealand College of Anaesthetists; Faculty of Pain Medicine. PS61 BP Guidelines for the Management of Evolving Airway Obstruction: Transition to the Can’t Intubate Can’t Oxygenate Airway Emergency. Available from URL: (accessed March 2021).
    1. Quintard H, l’Her E, Pottecher J, et al. Intubation and extubation of the ICU patient. Anaesth Crit Care Pain Med 2017; 36: 327-41.
    1. Mushambi MC, Kinsella SM, Popat M, et al. Obstetric Anaesthetists’ Association and Difficult Airway Society guidelines for the management of difficult and failed tracheal intubation in obstetrics. Anaesthesia. 2015;70:1286–1306.
    1. Ramkumar V, Dinesh E, Shetty SR, et al. All India Difficult Airway Association 2016 guidelines for the management of unanticipated difficult tracheal intubation in obstetrics. Indian J Anaesth. 2016;60:899–905.
    1. Gruppo di Studio SIAARTI “Vie Aeree Difficili”; Frova G, Guarino A, Petrini F, et al. Recommendations for airway control and difficult airway management in paediatric patients. Minerva Anestesiol 2006; 72: 723-48.
    1. Black AE, Flynn PE, Smith HL, Thomas ML, Wilkinson KA; Association of Pediatric Anaesthetists of Great Britain and Ireland. Development of a guideline for the management of the unanticipated difficult airway in pediatric practice. Paediatr Anaesth 2015; 25: 346-62.
    1. Pawar DK, Doctor JR, Raveendra US, et al. All India Difficult Airway Association 2016 guidelines for the management of unanticipated difficult tracheal intubation in paediatrics. Indian J Anaesth. 2016;60:906–914.
    1. Galvez JA, Acquah S, Ahumada L, et al. Hypoxemia, bradycardia, and multiple laryngoscopy attempts during anesthetic induction in infants: a single-center, retrospective study. Anesthesiology. 2019;131:830–839.
    1. Amalric M, Larcher R, Brunot V, et al. Impact of videolaryngoscopy expertise on first-attempt intubation success in critically ill patients. Crit Care Med. 2020;48:e889–e896.
    1. Humphreys S, von Ungern-Sternberg BS, Skowno J, et al. High-flow oxygen for children’s airway surgery: randomised controlled trial protocol (HAMSTER) BMJ Open. 2019 doi: 10.1136/bmjopen-2019-031873.
    1. Norris A, Heidegger T. Limitations of videolaryngoscopy. Br J Anaesth. 2016;117:148–150.
    1. Paton L, Gupta S, Blacoe D. Successful use of sugammadex in a ‘can’t ventilate’ scenario. Anaesthesia. 2013;68:861–864.
    1. Kleine-Brueggeney M, Theiler L, Urwyler N, Vogt A, Greif R. Randomized trial comparing the i-gel™ and Magill tracheal tube with the single-use ILMA™ and ILMA™ tracheal tube for fibreoptic-guided intubation in anaesthetized patients with a predicted difficult airway. Br J Anaesth. 2011;107:251–257.
    1. van Zundert TC, Wong DT, van Zundert AA. The LMA-Supreme™ as an intubation conduit in patients with known difficult airways: a prospective evaluation study. Acta Anaesthesiol Scand. 2013;57:77–81.
    1. Lenhardt R, Burkhart MT, Brock GN, Kanchi-Kandadai S, Sharma R, Akca O. Is video laryngoscope-assisted flexible tracheoscope intubation feasible for patients with predicted difficult airway? A prospective, randomized clinical trial. Anesth Analg. 2014;118:1259–1265.
    1. Pieters BM, Theunissen M, van Zundert AA. Macintosh blade videolaryngoscopy combined with rigid Bonfils intubation endoscope offers a suitable alternative for patients with difficult airways. Anesth Analg. 2018;126:988–994.
    1. Sowers N, Kovacs G. Use of a flexible intubating scope in combination with a channeled video laryngoscope for managing a difficult airway in the emergency department. J Emerg Med. 2016;50:315–319.
    1. Soltesz S, Alm P, Mathes A, Hellmich M, Hinkelbein J. The effect of neuromuscular blockade on the efficiency of facemask ventilation in patients difficult to facemask ventilate: a prospective trial. Anaesthesia. 2017;72:1484–1490.
    1. Joffe AM, Ramaiah R, Donahue E, et al. Ventilation by mask before and after the administration of neuromuscular blockade: a pragmatic non-inferiority trial. BMC Anesthesiol. 2015 doi: 10.1186/s12871-015-0111-z.
    1. Sachdeva R, Kannan TR, Mendonca C, Patteril M. Evaluation of changes in tidal volume during mask ventilation following administration of neuromuscular blocking drugs. Anaesthesia. 2014;69:826–831.
    1. Ikeda A, Isono S, Sato Y, et al. Effects of muscle relaxants on mask ventilation in anesthetized persons with normal upper airway anatomy. Anesthesiology. 2012;117:487–493.
    1. Simons DJ, Rensink RA. Change blindness: past, present, and future. Trends Cogn Sci. 2005;9:16–20.
    1. Jensen MS, Yao R, Street WN, Simons DJ. Change blindness and inattentional blindness. Wiley Interdiscip Rev Cogn Sci. 2011;2:529–546.
    1. Pattni N, Arzola C, Malavade A, Varmani S, Krimus L, Friedman Z. Challenging authority and speaking up in the operating room environment: a narrative synthesis. Br J Anaesth. 2019;122:233–244.
    1. Nielsen RP, Nikolajsen L, Paltved C, Aagaard R. Effect of simulation-based team training in airway management: a systematic review. Anaesthesia. 2021 doi: 10.1111/anae.15375.
    1. Dillon JK, Christensen B, Fairbanks T, Jurkovich G, Moe KS. The emergent surgical airway: cricothyrotomy vs. tracheotomy. Int J Oral Maxillofac Surg 2013; 42: 204-8.
    1. Duggan LV, Lockhart SL, Cook TM, O’Sullivan EP, Dare T, Baker PA. The Airway App: exploring the role of smartphone technology to capture emergency front-of-neck airway experiences internationally. Anaesthesia. 2018;73:703–710.
    1. Aziz S, Foster E, Lockey DJ, Christian MD. Emergency scalpel cricothyroidotomy use in a prehospital trauma service: a 20-year review. Emerg Med J. 2021 doi: 10.1136/emermed-2020-210305.
    1. Law JA. Deficiencies in locating the cricothyroid membrane by palpation: we can’t and the surgeons can’t, so what now for the emergency surgical airway? Can J Anesth. 2016;63:791–796.
    1. Drew T, McCaul CL. Laryngeal handshake technique in locating the cricothyroid membrane: a non-randomised comparative study. Br J Anaesth. 2018;121:1173–1178.
    1. Cook TM, Harrop-Griffiths AW, Whitaker DK, McNarry AF, Patel A, McGuire B. The ‘No Trace=Wrong Place’ campaign. Br J Anaesth. 2019;122:e68–e69.
    1. Kim MS, Park JH, Lee KY, et al. Influence of head and neck position on the performance of supraglottic airway devices: a systematic review and meta-analysis. PLoS One. 2019 doi: 10.1371/journal.pone.0216673.
    1. Cook TM, Kelly FE, Goswami A. ‘Hats and caps’ capnography training on intensive care. Anaesthesia. 2013 doi: 10.1111/anae.12173.
    1. Linko K, Paloheimo M, Tammisto T. Capnography for detection of accidental oesophageal intubation. Acta Anaesthesiol Scand. 1983;27:199–202.
    1. Vithalani VD, Vlk S, Davis SQ, Richmond NJ. Unrecognized failed airway management using a supraglottic airway device. Resuscitation. 2017;119:1–4.
    1. Link MS, Berkow LC, Kudenchuk PJ, et al. Part 7: Adult Advanced Cardiovascular Life Support: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2015;132(18 Suppl 2):S444–S464.
    1. Cook TM, Nolan JP. Use of capnography to confirm correct tracheal intubation during cardiac arrest. Anaesthesia. 2011;66:1183–1184.
    1. Jafferji D, Morris R, Levy N. Reducing the risk of confirmation bias in unrecognised oesophageal intubation. Br J Anaesth. 2019;122:e66–e68.
    1. Takeda T, Tanigawa K, Tanaka H, Hayashi Y, Goto E, Tanaka K. The assessment of three methods to verify tracheal tube placement in the emergency setting. Resuscitation. 2003;56:153–157.
    1. Grmec S. Comparison of three different methods to confirm tracheal tube placement in emergency intubation. Intensive Care Med. 2002;28:701–704.
    1. Grmec S, Mally S. Prehospital determination of tracheal tube placement in severe head injury. Emerg Med J. 2004;21:518–520.
    1. Goldberg JS, Rawle PR, Zehnder JL, Sladen RN. Colorimetric end-tidal carbon dioxide monitoring for tracheal intubation. Anesth Analg. 1990;70:191–194.
    1. Knapp S, Kofler J, Stoiser B, et al. The assessment of four different methods to verify tracheal tube placement in the critical care setting. Anesth Analg. 1999;88:766–770.
    1. Gomes SB, Mychaskiw G., 2nd Failure of the Easy Cap II CO2 detector to indicate esophageal intubation. J Clin Anesth. 2012;24:352–353.
    1. Ornato JP, Shipley JB, Racht EM, et al. Multicenter study of a portable, hand-size, colorimetric end-tidal carbon dioxide detection device. Ann Emerg Med. 1992;21:518–523.
    1. Anton WR, Gordon RW, Jordan TM, Posner KL, Cheney FW. A disposable end-tidal CO2 detector to verify endotracheal intubation. Ann Emerg Med. 1991;20:271–275.
    1. MacLeod BA, Heller MB, Gerard J, Yealy DM, Menegazzi JJ. Verification of endotracheal tube placement with colorimetric end-tidal CO2 detection. Ann Emerg Med. 1991;20:267–270.
    1. Bhende MS, Thompson AE. Evaluation of an end-tidal CO2 detector during pediatric cardiopulmonary resuscitation. Pediatrics. 1995;95:395–399.
    1. Schmolzer GM, Poulton DA, Dawson JA, Kamlin CO, Morley CJ, Davis PG. Assessment of flow waves and colorimetric CO2 detector for endotracheal tube placement during neonatal resuscitation. Resuscitation. 2011;82:307–312.
    1. Srinivasa V, Kodali BS. Caution when using colorimetry to confirm endotracheal intubation. Anesth Analg. 2007 doi: 10.1213/01.ane.0000253918.18547.13.
    1. Hughes SM, Blake BL, Woods SL, Lehmann CU. False-positive results on colorimetric carbon dioxide analysis in neonatal resuscitation: potential for serious patient harm. J Perinatol. 2007;27:800–801.
    1. Kovacs G, Duggan LV, Brindley PG. Glottic impersonation. Can J Anesth. 2017 doi: 10.1007/s12630-016-0804-x.
    1. Alabbad SI, Shaw K, Puligandla PS, Carranza R, Bernard C, Laberge JM. The pitfalls of endotracheal intubation beyond the fistula in babies with type C esophageal atresia. Semin Pediatr Surg. 2009;18:116–118.
    1. Taneja B, Saxena KN. Endotracheal intubation in a neonate with esophageal atresia and trachea-esophageal fistula: pitfalls and techniques. J Neonatal Surg. 2014 doi: 10.47338/jns.v3.82.
    1. Lin MJ, Gurley K, Hoffmann B. Bedside ultrasound for tracheal tube verification in pediatric emergency department and ICU patients: a systematic review. Pediatr Crit Care Med. 2016;17:e469–e476.
    1. Gottlieb M, Holladay D, Peksa GD. Ultrasonography for the confirmation of endotracheal tube intubation: a systematic review and meta-analysis. Ann Emerg Med. 2018;72:627–636.
    1. Das SK, Choupoo NS, Haldar R, Lahkar A. Transtracheal ultrasound for verification of endotracheal tube placement: a systematic review and meta-analysis. Can J Anesth. 2015;62:413–423.
    1. Chou EH, Dickman E, Tsou PY, et al. Ultrasonography for confirmation of endotracheal tube placement: a systematic review and meta-analysis. Resuscitation. 2015;90:97–103.
    1. Andersen KH, Hald A. Assessing the position of the tracheal tube. The reliability of different methods. Anaesthesia. 1989;44:984–985.
    1. Qi L, Liu R, Tang E, et al. A comparison of degree of precision of auscultation, partial pressure of carbon dioxide in end-expiration, and transillumination technique in verifying accurate position of endotracheal tube (Chinese) Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2015;27:826–830.
    1. Sharieff GQ, Rodarte A, Wilton N, Bleyle D. The self-inflating bulb as an airway adjunct: is it reliable in children weighing less than 20 kilograms? Acad Emerg Med. 2003;10:303–308.
    1. Sharieff GQ, Rodarte A, Wilton N, Silva PD, Bleyle D. The self-inflating bulb as an esophageal detector device in children weighing more than twenty kilograms: a comparison of two techniques. Ann Emerg Med. 2003;41:623–629.
    1. Heidegger T, Heim C. Esophageal detector device: not always reliable. Ann Emerg Med. 1996 doi: 10.1016/s0196-0644(96)70125-7.
    1. Marley CD, Jr, Eitel DR, Anderson TE, Murn AJ, Patterson GA. Evaluation of a prototype esophageal detection device. Acad Emerg Med. 1995;2:503–507.
    1. Kasper CL, Deem S. The self-inflating bulb to detect esophageal intubation during emergency airway management. Anesthesiology. 1998;88:898–902.
    1. Wafai Y, Salem MR, Joseph NJ, Baraka A. The self-inflating bulb for confirmation of tracheal intubation: incidence and demography of false negatives. Anesthesiology. 1994;81(3A):A1303.
    1. Wee MY, Walker AK. The oesophageal detector device. An assessment with uncuffed tubes in children. Anaesthesia 1991; 46: 869-71.
    1. Salem MR, Wafai Y, Baraka A, Taimorrazy B, Joseph NJ, Nimmagadda U. Use of the self-inflating bulb for detecting esophageal intubation after “esophageal ventilation”. Anesth Analg. 1993;77:1227–1231.
    1. Haridas RP. Condensation on tracheal tubes is commonly seen with oesophageal intubation. Br J Anaesth. 1995;75:115–116.
    1. Gillespie JH, Knight RG, Middauch RE, Menk EJ, Baysinger CL. Efficacy of endotracheal tube cuff palpation and humidity in distinguishing endotracheal from esophageal intubation. Anesthesiology. 1988;69(Suppl. 3A):A265.
    1. Pollard R, Wagner M, Grichnik K, Clyne BC, Habib AS. Prevalence of difficult intubation and failed intubation in a diverse obstetric community-based population. Curr Med Res Opin. 2017;33:2167–2171.
    1. Quinn AC, Milne D, Columb M, Gorton H, Knight M. Failed tracheal intubation in obstetric anaesthesia: 2 yr national case-control study in the UK. Br J Anaesth. 2013;110:74–80.
    1. Djabatey EA, Barclay PM. Difficult and failed intubation in 3430 obstetric general anaesthetics. Anaesthesia. 2009;64:1168–1171.
    1. Palanisamy A, Mitani AA, Tsen LC. General anesthesia for cesarean delivery at a tertiary care hospital from 2000 to 2005: a retrospective analysis and 10-year update. Int J Obstet Anesth. 2011;20:10–16.
    1. Boutonnet M, Faitot V, Katz A, Salomon L, Keita H. Mallampati class changes during pregnancy, labour, and after delivery: can these be predicted? Br J Anaesth. 2010;104:67–70.
    1. Mushambi MC, Athanassoglou V, Kinsella SM. Anticipated difficult airway during obstetric general anaesthesia: narrative literature review and management recommendations. Anaesthesia. 2020;75:945–961.
    1. Kodali BS, Chandrasekhar S, Bulich LN, Topulos GP, Datta S. Airway changes during labor and delivery. Anesthesiology. 2008;108:357–362.
    1. You-Ten KE, Desai D, Postonogova T, Siddiqui N. Accuracy of conventional digital palpation and ultrasound of the cricothyroid membrane in obese women in labour. Anaesthesia. 2015;70:1230–1234.
    1. Teoh WH, Kristensen MS. Ultrasonographic identification of the cricothyroid membrane. Anaesthesia. 2014;69:649–650.
    1. Au K, Shippam W, Taylor J, Albert A, Chau A. Determining the effective pre-oxygenation interval in obstetric patients using high-flow nasal oxygen and standard flow rate facemask: a biased-coin up-down sequential allocation trial. Anaesthesia. 2020;75:609–616.
    1. Shippam W, Preston R, Douglas J, Taylor J, Albert A, Chau A. High-flow nasal oxygen vs. standard flow-rate facemask pre-oxygenation in pregnant patients: a randomised physiological study. Anaesthesia 2019; 74: 450-6.
    1. Tan PC, Millay OJ, Leeton L, Dennis AT. High-flow humidified nasal preoxygenation in pregnant women: a prospective observational study. Br J Anaesth. 2019;122:86–91.
    1. Phillips S, Subair S, Husain T, Sultan P. Apnoeic oxygenation during maternal cardiac arrest in a parturient with extreme obesity. Int J Obstet Anesth. 2017;29:88–90.
    1. Howle R, Onwochei D, Harrison SL, Desai N. Comparison of videolaryngoscopy and direct laryngoscopy for tracheal intubation in obstetrics: a mixed-methods systematic review and meta-analysis. Can J Anesth. 2021;68:546–565.
    1. Habib AS. Is it time to revisit tracheal intubation for cesarean delivery? Can J Anesth. 2012;59:642–647.
    1. Fang X, Xiao Q, Xie Q, et al. General anesthesia with the use of SUPREME laryngeal mask airway for emergency cesarean delivery: a retrospective analysis of 1039 parturients. Sci Rep. 2018 doi: 10.1038/s41598-018-31581-5.
    1. Metodiev Y, Mushambi M. Supraglottic airway devices for caesarean delivery under general anaesthesia: for all, for none, or for some? Br J Anaesth. 2020;125:e7–e11.
    1. Bamber J, Lucas N; MBRRACE-UK Indirect Chapter-Writing Group. Improving anaesthetic care. In: Knight M, Bunch K, Tuffnell D, Shakespeare J, Kotnis R, Kenyon S, Kurinczuk JJ (Eds) on behalf of MBRRACE-UK. Saving Lives, Improving Mothers’ Care - Lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2016-18. Oxford: National Perinatal Epidemiology Unit, University of Oxford; 2020: 43-7.
    1. Hawkins JL, Chang J, Palmer SK, Gibbs CP, Callaghan WM. Anesthesia-related maternal mortality in the United States: 1979-2002. Obstet Gynecol. 2011;117:69–74.
    1. Bunchungmongkol N, Somboonviboon W, Suraseranivongse S, Vasinanukorn M, Chau-in W, Hintong T. Pediatric anesthesia adverse events: the Thai Anesthesia Incidents Study (THAI Study) database of 25,098 cases. J Med Assoc Thai. 2007;90:2072–2079.
    1. Engelhardt T, Fiadjoe JE, Weiss M, et al. A framework for the management of the pediatric airway. Paediatr Anaesth. 2019;29:985–992.
    1. Weingart SD, Levitan RM. Preoxygenation and prevention of desaturation during emergency airway management. Ann Emerg Med 2012; 59: 165-75.e1.
    1. Huang AS, Sarver A, Widing A, Hajduk J, Jagannathan N. The design of the perfect pediatric supraglottic airway device. Paediatr Anaesth. 2020;30:280–287.
    1. Burjek NE, Nishisaki A, Fiadjoe JE, et al. Videolaryngoscopy versus fiber-optic intubation through a supraglottic airway in children with a difficult airway: an analysis from the multicenter pediatric difficult intubation registry. Anesthesiology. 2017;127:432–440.
    1. Jagannathan N, Sohn LE, Mankoo R, Langen KE, Mandler T. A randomized crossover comparison between the Laryngeal Mask Airway-Unique™ and the air-Q intubating laryngeal airway in children. Paediatr Anaesth. 2012;22:161–167.
    1. Weiss M, Engelhardt T. Using cuffed tracheal tubes below recommended body weight: compromising safety or exploring limits safely? Paediatr Anaesth. 2018;28:193–194.
    1. Johansen K, Holm-Knudsen RJ, Charabi B, Kristensen MS, Rasmussen LS. Cannot ventilate-cannot intubate an infant: surgical tracheotomy or transtracheal cannula? Paediatr Anaesth. 2010;20:987–993.
    1. Morrison S, Aerts S, Saldien V. The Ventrain device: a future role in difficult airway algorithms? A A Pract. 2019;13:362–365.
    1. Mann CM, Baker PA, Sainsbury DM, Taylor R. A comparison of cannula insufflation device performance for emergency front of neck airway. Paediatr Anaesth. 2021 doi: 10.1111/pan.14128.
    1. Flin R, Fioratou E, Frerk C, Trotter C, Cook TM. Human factors in the development of complications of airway management: preliminary evaluation of an interview tool. Anaesthesia. 2013;68:817–825.
    1. Rozenfeld RA, Nannicelli AP, Brown AR, et al. Verbal communication during airway management and emergent endotracheal intubation: observations of team behavior among multi-institutional pediatric intensive care unit in situ simulations. J Patient Saf. 2016 doi: 10.1097/PTS.0000000000000272.
    1. Petrosoniak A, Hicks CM. Beyond crisis resource management: new frontiers in human factors training for acute care medicine. Curr Opin Anaesthesiol. 2013;26:699–706.
    1. Janz DR, Semler MW, Joffe AM, et al. A multicenter randomized trial of a checklist for endotracheal intubation of critically ill adults. Chest. 2018;153:816–824.
    1. Burgess MR, Crewdson K, Lockey DJ, Perkins ZB. Prehospital emergency anaesthesia: an updated survey of UK practice with emphasis on the role of standardisation and checklists. Emerg Med J. 2018;35:532–537.
    1. Hardy G, Horner D. BET 2: should real resuscitationists use airway checklists? Emerg Med J. 2016;33:439–441.
    1. Turner JS, Bucca AW, Propst SL, et al. Association of checklist use in endotracheal intubation with clinically important outcomes: a systematic review and meta-analysis. JAMA Netw Open. 2020 doi: 10.1001/jamanetworkopen.2020.9278.
    1. Schulz CM, Burden A, Posner KL, et al. Frequency and type of situational awareness errors contributing to death and brain damage: a closed claims analysis. Anesthesiology. 2017;127:326–337.
    1. LeBlanc VR. The effects of acute stress on performance: implications for health professions education. Acad Med. 2009;84(10 Suppl):S25–S33.
    1. Salik I, Ashurst JV. Closed Loop Communication Training in Medical Simulation. Treasure Island, FL: StatPearls; 2020.
    1. McNarry AF, Cook TM, Baker PA, O’Sullivan EP. The airway lead: opportunities to improve institutional and personal preparedness for airway management. Br J Anaesth. 2020;125:e22–e24.
    1. Lundstrom LH, Moller AM, Rosenstock C, et al. A documented previous difficult tracheal intubation as a prognostic test for a subsequent difficult tracheal intubation in adults. Anaesthesia. 2009;64:1081–1088.
    1. Scott Beattie W, Culwick MD, Grocott HP. Canadian Anesthesia Incident Reporting System (CAIRS): the Canadian Anesthesiologists’ Society’s National Patient Safety Initiative. Can J Anesth. 2018;65:749–756.
    1. Shanahan E, Huang JH, Chen A, Narsimhan A, Tang R. - a difficult airway electronic record. Can J Anesth 2016; 63: 1299-300.
    1. Ericsson KA. Acquisition and maintenance of medical expertise: a perspective from the expert-performance approach with deliberate practice. Acad Med. 2015;90:1471–1486.
    1. Pusic MV, Kessler D, Szyld D, Kalet A, Pecaric M, Boutis K. Experience curves as an organizing framework for deliberate practice in emergency medicine learning. Acad Emerg Med. 2012;19:1476–1480.
    1. Ericsson KA. Deliberate practice and acquisition of expert performance: a general overview. Acad Emerg Med. 2008;15:988–994.
    1. Issenberg SB, McGaghie WC, Petrusa ER, Lee Gordon D, Scalese RJ. Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review. Med Teach. 2005;27:10–28.
    1. Bould MD, Crabtree NA, Naik VN. Assessment of procedural skills in anaesthesia. Br J Anaesth. 2009;103:472–483.
    1. Baker PA, Greif RT. Airway management education. In: Hagberg CA, Artime C, Aziz MF, editors. Hagberg and Benumof’s Airway Management. 4. Philadelphia: Elsevier; 2018. pp. 891–910.
    1. Alfery DD, Ezri T, Ghelber O, Szmuk P. Teaching airway management is dependent on the knowledge of the teachers. Acta Anaesthesiol Scand 2006; 50: 895-6; author reply 896-7.
    1. Crosby ET. An evidence-based approach to airway management: is there a role for clinical practice guidelines? Anaesthesia. 2011;66(Suppl 2):112–118.
    1. Chrimes N, Cook TM. Critical airways, critical language. Br J Anaesth. 2017;118:649–654.
    1. Chrimes N, Higgs A, Sakles JC. Welcome to the era of universal airway management. Anaesthesia. 2020;75:711–715.

Source: PubMed

Sponsors en medewerkers

Medische omstandigheden

Geneesmiddelinterventies

3
Abonneren