Criteria used to decide to waken or proceed with surgery following failed tracheal intubation in a pregnant patient

Before induction of anesthesia, the anesthesia and obstetric teams should discuss whether to wake the patient or continue anesthesia in the event of a failed intubation. The factors to consider are shown in the top portion of this table, labeled preinduction planning. In particular, the anesthetist should consider whether it would be appropriate to use a supraglottic airway for the duration of surgery.
The bottom portion of the table shows the additional airway-related factors to consider after attempted intubation fails.
In any individual patient some factors may suggest wakening the patient and others may suggest proceeding with surgery. The final decision to waken or proceed will depend on the anesthetist's clinical judgement.

Modified from: Mushambi MC, Kinsella SM, Popat M, et al. Obstetric Anaesthetists' Association and Difficult Airway Society guidelines for the management of difficult and failed tracheal intubation in obstetrics. Anaesthesia 2015; 70(11):1286-1306. https://onlinelibrary.wiley.com/doi/full/10.1111/anae.13260. Copyright © 2015 The Authors. Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of Anaesthetists of Great Britain and Ireland. Reproduced with permission of John Wiley & Sons Inc. This image has been provided by or is owned by Wiley. Further permission is needed before it can be downloaded to PowerPoint, printed, shared or emailed. Please contact Wiley's permissions department either via email: [email protected] or use the RightsLink service by clicking on the 'Request Permission' link accompanying this article on Wiley Online Library (https://onlinelibrary.wiley.com/).

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Criteria used to decide to waken or proceed with surgery following failed tracheal intubation in a pregnant patient