ASA DIFFICULT AIRWAY ALGORITHM

BASICS:

Evaluation of the Informing the Availability of

Airway patient/Bystander equipment

Optimise the
Availability of a
position /
Trained Assistant
Preoxygenation
CONSIDER THE BASIC MANAGEMENT
CHOICES
• Awake Intubtn vs. Intubtn after
induction of GA

• Non-Inv. vs. Inv. Techniques initial

approach

• VAL as an initial approach to

intubation

• Preservation vs. ablation of spont.

ventilation
 THROUGHOUT THE PROCESS OF
DIFFICULT AIRWAY

 Actively deliver supplemental OXYGEN

 AWAKE INTUBATION

Airway approached by Invasive Airway Access

NON Invasive Airway Access

Succeed Fail

Cancel case Invasive airway access

Consider feasibility of other options

 INTUBATION AFTER INDUCTION OF GA

INITIAL INTUB UNSUCCESSFUL

FROM THIS POINT ONWARDS CONSIDER
INITIAL INTUBATION ATTEMPTS SUCCESSFUL
1. CALL FOR HELP
2.Return to spont ventilation
3.Awaken
 INITIAL INTUBATION ATTEMPTS UNSUCCESSFUL

FACE MASK VENTILATION ADEQUATE FACE MASK VENTILATION NOT ADEQUATE

 FACE MASK VENTILATION ADEQUATE

NONEMERGENCY PATHWAY
Ventilation adequate, intubation unsuccessful

Alternative approaches to intubation

SUCCESSFUL INTUBATION FAIL AFTER MULTIPLE ATTEMPTS

INVASIVE AIRWAY ACCESS CONSIDER FEASIBILTY OF OTHER OPTIONS AWAKEN THE PATIENT
 FACE MASK VENTILATION NOT ADEQUATE
CONSIDER/ATTEMPT SGA

SGA NOT ADEQUATE OR NOT FEASIBLE

SGA ADEQUATE
EMERGENCY PATHWAY
Ventilation not adequate, intubation unsuccessful

Call for help

Emergency NON invasive airway ventilation

FAIL
Successful ventilation Emergency invasive airway access

Invasive airway access Awaken the patient

Consider feasibility of other options
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FVK
HJU
THANK
YOU !