Preoperative management
A routine proper preoperative assessment was done and the condition explained to the patient and an informed written consent was taken. The patient was kept fasting for six hours and premedicated.
The preoperative investigations were done and the results were within the normal limits.
The management in the operation theater
The management was planned as for a patient with a difficult airway. The following airway equipments were prepared. Masks, LMA sizes 2.5,3,4 , two Laryngoscopes …show more content…
A difficult airway could be encountered at various level of care and the prior preparation is important for successful management.
The Difficult Airway
Difficult airway is defined as the clinical situation in which a conventionally trained anesthesiologist experiences difficulty with facemask ventilation of the upper airway, difficulty with tracheal intubation, or both.
The difficult airway represents a complex interaction between patient factors, the clinical setting, and the skills of the practitioner. Airway difficulties are more than just difficulties in intubating and can be categorized according to the different components of airway management and they are the difficult basic airway manoeuvres, the difficult mask ventilation, difficult laryngoscopy, difficult intubation and difficult cricothyroidotomy
Difficult in basic airway manoeuvres occur in situations like limited neck mobility causing difficulties in head tilt facial fractures limiting jaw thrust, trismus preventing insertion of oropharyngeal airway and nasal deformity preventing insertion of a nasopharyngeal …show more content…
The difficult airway society algorithm lays out a management strategy as plan A, B, C and D according to the severity for unanticipated difficult intubation. When an unanticipated difficult intubation is encountered the plan A is implemented that is Initial intubation plan. Manoeuvres to improve the laryngoscope views such as neck flexion and head extension, external laryngeal manipulation, using bougie etc. are used and maximum four attempts of intubation can be attempted while maintaining oxygenation and anaesthesia. If intubation is not successful then we have to move to plan