**4. Preintubation check list**


**57**

(**Figure 2**) [15].

*ventilation, SGA = Supraglottis airway.*

**Figure 2.**

**5.1 Preoxygenation**

intubation [16].

intubate:

**5. Suggested airway management technique**

• Group 1 (G1): Those at low risk of difficulty.

*Airway Trauma: Assessment and Management DOI: http://dx.doi.org/10.5772/intechopen.96894*

The optimal airway management depends on the availability of expertise and equipment, not the location of the care. Communication should be clear between team members, concerning the airway plan and the role of each of them. Regardless of who oversees airway management, it should be clear who will make the decision to proceed and who will perform the procedure if a cricothyrotomy or surgical airway is required. Reardon et al. suggested airway management algorithm

*Airway management algorithm (SO2 = oxygen saturation, RSI = rapid sequence induction, DL = direct laryngoscopy, VL = video laryngoscopy, ILMA = intubating laryngeal mask airway, BMV=bag mask* 

Preoxygenation is critical to success and safety of emergency intubation, especially when rapid sequence induction and intubation (RSI) is used. The best way to provide high fraction of inspired oxygen (FiO2; 100) for preoxygenation is by using a standard reservoir facemask with the oxygen flow rate set as high as possible. Patients should be preoxygenated for 3 min or 8 maximal capacity breaths if time is short. It is best to preoxygenate patients in a head-elevated position or in reverse Trendelenburg, especially if the patient is obese. Apneic oxygenation is a relatively new concept that can help prevent oxygen desaturation during RSI. This is best accomplished by placing a nasal cannula (with an oxygen flow rate more than 15 L/min) under the facemask during preoxygenation and leaving it in place during

Patients may be classified into the following three groups when deciding how to


*Airway Trauma: Assessment and Management DOI: http://dx.doi.org/10.5772/intechopen.96894*

**Figure 2.**

*Special Considerations in Human Airway Management*

If airway is maintained and there is no need for intubation, then computerized Tomography (CT) and Magnetic Resonance Imaging (MRI) can be performed. Imaging provides comprehensive information about airway and surrounding.

Virtual endoscopy and 3-D reconstruction of upper airway could be done, and all the injuries are identified, and the risk of airway compression is evaluated (**Figure 1**). Once the airway risk assessment is done, the choice of airway management and

possible interventions should be planned before the induction of anaesthesia.

*3-D CT reconstruction showing loose teeth and bone that can cause airway obstruction.*

8.Intravenous line functioning (and blood pressure cuff on opposite arm)

10.Medications drawn up (including paralytic, even if not planning to use it)

9.Assistant designated to provide manual in-line stabilization (MILS)

1.Oxygen mask and nasal cannula oxygen running

**4. Preintubation check list**

3.Bag Mask Value (BMV) ready

5.Laryngoscope functioning

6.Endotracheal tube (ETT)

4.Different sizes of Guedel's oral airway

7.Supraglottis airway (SGA) device ready

11.Patient position optimized (if possible)

12.Airway plan verbalized with all personnel involved

2.Suction working

**Figure 1.**

**56**

*Airway management algorithm (SO2 = oxygen saturation, RSI = rapid sequence induction, DL = direct laryngoscopy, VL = video laryngoscopy, ILMA = intubating laryngeal mask airway, BMV=bag mask ventilation, SGA = Supraglottis airway.*

The optimal airway management depends on the availability of expertise and equipment, not the location of the care. Communication should be clear between team members, concerning the airway plan and the role of each of them. Regardless of who oversees airway management, it should be clear who will make the decision to proceed and who will perform the procedure if a cricothyrotomy or surgical airway is required. Reardon et al. suggested airway management algorithm (**Figure 2**) [15].
