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Management of the difficult airway

Jon Smally A, Anthony Nowicki T

Department of Traumatology and Emergency Medicine. Hartford Hospital and the University of Connecticut, Hartford, USA.

Airway management is the cornerstone of Emergency Medicine. The Emergency
Physician (EP) must be able to protect the airway, oxygenate, and ventilate patients of all
ages and sizes including those possessing multiple markers of potential difficult
intubation. In many situations there will not be available backup for the EP and no
possibility of deferring the procedure (“cancelling the case”) due to the patient’s
extremis. Fortunately, experienced and trained EP’s are able to achieve control of the
airway in the vast majority of cases with sedation or rapid sequence intubation (RSI) with
paralysis and direct laryngoscopy (DL). In this Review/Point of View report we will outline
a method of preparation, approach, and use of equipment that should reduce the
chance of an adverse or even catastrophic outcome in your practice.

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