**10.6 Tube selection**

Endotracheal tubes should be selected according to the nature of the surgical procedure, age and body weight, but their size, composition material, length, etc. can influence the ease of intubation. A smaller tube usually is easier to be inserted because of a better view of the laryngeal inlet during the passage of the tube between the cords. Smaller tubes are less likely to cause trauma [53]. 'Hold-up' at the arytenoids is a feature of the left-facing bevel of most tracheal tubes and can occur whilst railroading larger tubes over a bougie, stylet, or fibrescope [54]. This problem can be solved by rotating the tube anticlockwise to change the orientation of the bevel (**Figure 5**).

#### **Figure 4.**

*Different laryngoscopes. From left to right: Traditional Macintosh, McGrath Videolaryngoscope and Airtraq Videolaryngospe.*

**301**

**Author details**

**11. Conclusions**

Extremadura (SEXMICYUC), Badajoz, Spain

provided the original work is properly cited.

\*Address all correspondence to: dpcivantos@gmail.com

*Management of New Special Devices for Intubation in Difficult Airway Situations*

Managing the airway in Covid-19 pandemia have led intensivists to a point of maximum risk of exposition to the virus due to aerosols and high proximity to the patient's airway. It has been endorsed by many studies and many medical scientific societies the safety use of all personal protective equipment throughout the intubation process. It is also advised to avoid BMV if possible and when the situation allows to pre-oxygenate with a high-flow non-rebreathing mask or high-flow humidified nasal cannulae, then using RSI with a hypnotic drug and rapid depolarizing NBA. Small endotracheal tubes are not recommended due to the predicted long period of mechanical intubation and frequent plugs of mucous that interfere

Intubation, the approach to a DA and the management of the different aspects of the human airway is an intrinsic domain that is supposed to be mastered by the anesthesiologist, the intensivist and the emergency physician, since all of them can face any difficult situation and life-threatening situation involving the airway. It is also of utmost importance to have an experienced and rehearsed team, as well as a revised and well-equipped mobile chart with all the necessary material to successfully face any potentially threatening situation related to airway management. Knowing and practising under a well-coordinated guide or protocol is the

We have updated and compiled relevant information on how to manage a DA crisis knowing the best available possibilities to prevail in such problematic situations.

best way to overcome any potential airway life-threatening situation.

Demetrio Pérez-Civantos\*, Alicia Muñoz-Cantero, Francisco Fuentes Morillas, Pablo Nieto Sánchez, María Ángeles Santiago Triviño and Natalia Durán Caballero Faculty of Medicine, Intensive Care Department, Badajoz University Hospital, University of Extremadura, Society of Intensive and Critical Care Medicine of

© 2021 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium,

*DOI: http://dx.doi.org/10.5772/intechopen.97400*

**10.7 Special situations such as Covid-19 pandemia**

with the patient's adequate ventilation and oxygenation.

**Figure 5.** *Single-use fiberoptic bronchoscope.*
