*2.3.1 Post-intubation care*

*Special Considerations in Human Airway Management*

on CICO declaration [19].

opening the set after one failed attempt of plan B/C and immediate FONA set use

FONA either scalpel cricothyroidotomy or other techniques; which need experience, specific preparations and include non-scalpel cricothyroidotomy, percutaneous tracheostomy and surgical tracheostomy. Scalpel cricothyroidotomy recommended in DAS guidelines offers the following advantages; timesaving, reliable, conducted in few steps with well-known immediately available equipment,

**94**

**Figure 8.**

*Plan D protocol in DAS/ICS/FICM/RCoA guidelines.*

Not only providing airway securing device in critically ill patients is highly challenging, but post airway securing maintenance is also important to prevent airway displacement or obstruction. In addition of airway care, sedation and/or muscle relaxation are typically administered. They are not only having high-risk during intubation but also afterwards in rates of 82%; airway displacement and blockage, with 25% leading to death [49].

Furthermore; postintubation hypoxia occurred from multiple attempts, interruption of oxygenation, alveolar de-recruitment and collapse, and changes in the alveolar gas exchange may indicate an increase in initial lung volumes settings and benefiting from recruitment manoeuvers [38].

Attention payed towards recognition of red flag in intubated patients such as absent air entry on auscultation, abnormal EtCO2, increasing peak airway pressure (PAP), unattained inhaled tidal volume and abnormal chest x-ray findings, mandate immediate management.
