Airway management for patients with airway compression

Awake intubation is recommended if the patient is cooperative, stable, and can maintain spontaneous ventilation, airway patency, and adequate O₂ saturation.

Personnel able to perform a surgical airway should be prepared to immediately intervene should life-threatening airway obstruction occur.

Consider opening the wound if an expanding postoperative neck hematoma is suspected.

Maintain spontaneous ventilation with induction of GA.

Position tracheal tube below level of obstruction. Fiberoptic confirmation may be required.

SGA is not recommended.

VAL and FSI are good choices as long as they allow visualizing airway.

O₂: oxygen; GA: general anesthesia; SGA: supraglottic airway devices; VAL: video-assisted laryngoscopy; FSI: flexible scope intubation.

Reproduced with permission from: Hagberg CA, Kaslow O. Difficult airway management algorithm in trauma: Updated by COTEP. ASA Monitor 2014; 78:56. Copyright © 2014 American Society of Anesthesiologists. Excerpted from ASA Monitor (2014) of the American Society of Anesthesiologists. A copy of the full text can be obtained from ASA, 1061 American Lane, Schaumburg, IL, 60173-4973 or online at www.asahq.org.

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Airway management for patients with airway compression