Difficult airway management - 2014

Difficult airway management is an urgent, life threatening situation, which is a nightmare of every anaesthesiologist. We can speak about difficult airway managent if we repeteadly cannot intubate or if it takes longer then 10 minutes. Difficult airway management it to be expected when the pacient has limited cervical spine movement, neck and face injury or in pregnancy.

Published at: 29.6.2014


Michal Otáhal, MD, PhD
Chief physician, Dept. of Anaesthesiology Intensive Care, 1st Faculty of Medicine, Charles University in Prague; General University Hospital, Prague, Czech Republic

This interactive case study represents illustrative case of upper airway obstruction, describing the following life-threatening situation and providing essential management of the patient describing possible solutions: attempt to intubation or intubation with aid - bougie. After the failure to intubate there is attempt to supraglottic airway management with laryngeal mask and the last opportunity, if this fails, infraglotic surgical approach - coniotomy or BACT (bougie assisted coniotomy). Instructional videos demonstrate the possibility of securing an airway. The nature of this interactive step-by-step case study, although very successfully created, does not show the severity of the condition and that the state of airway obstruction is accompanied by a need for very swift process: the failure to intubate -> failure to use laryngeal mask -> coniotomy / BACT .


BALCÁREK, Lukáš. Zajištění dýchacích cest v mimořádných podmínkách. Anesteziologie & intenzivní medicína. 2012, 23(4), 225. ISSN 1214-2158.

MÁLEK, Jiří. Obtížné zajištění dýchacích cest. Anesteziologie & intenzivní medicína. 2011, 22(3), 181-183. ISSN 1214-2158

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