Airway management: judgment and communication more than gadgets

Excerpt

Airway difficulties are probably the most dreaded complications in anesthesia. In contrast with most other adverse effects seen in our practice, the initial physical status of the patient has little to do with the risk associated with airway management. An otherwise healthy individual is just as likely as an American Society of Anesthesiologists class IV patient to suffer severe, if not lethal, consequences of poor oxygenation. In a much needed attempt to provide practicing anesthesiologists with safer and more effective methods, there has been an explosion of intubation tools and other airway devices during the past two decades or so. With this proliferation of technological aids, there arose a need to reactivate the Canadian Airway Focus Group, which produced its latest recommendations in 1998.1 Currently, the Group is made up of 14 airway experts from across Canada, four of whom were members of the original committee. In this issue of the Journal, the Group proposes a set of recommendations designed for two different contexts, the unanticipated difficult intubation2 and the anticipated difficult airway.3 …