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Articles written by MSc, BS. Khong Trong Thang, Emergency Resuscitation Department, Vinmec Central Park International General Hospital
Difficult intubation is when the intubation takes more than 10 minutes or requires more than three attempts. Difficult intubation, if not handled promptly, will cause dangerous complications such as severe hypoxia and cardiovascular collapse, leading to cardiac arrest, cerebral ischemia and death. Below is a flow chart of difficult intubation.
1. Clinical assessment of difficult airway control problems
Difficulty ventilating; Difficulty intubating; Difficult because the patient does not agree, does not cooperate; Tracheostomy is difficult.
2. Actively provide oxygen by measures during difficult airway management
3. Consider and select appropriate airway control measures
Các biện pháp kiểm soát đường thở thích hợp
Other options (not limited to) laryngeal mask surgery, plexus anesthesia, regional anesthesia. Use of these measures is only possible when ventilation is possible with a balloon mask. Therefore, these options are of limited value. Establish an airway by invasive measures including surgery, percutaneous tracheostomy, and cricoidectomy. The noninvasive approach to intubation is unlikely to use different endotracheal blade blades. Laryngeal mask (with or without flexible endoscope) endotracheal intubation, use of stylet, retrograde endotracheal intubation, cap placement over the nose or mouth. Consider preparing the patient for static intubation or canceling surgery. Options for noninvasive emergency ventilation include rigid bronchoscopes, combitubes, and jet ventilation. Difficult intubation should be performed by highly qualified, experienced physicians. Vinmec International General Hospital is a high-quality medical facility in Vietnam with a team of highly qualified medical professionals, well-trained, domestic and foreign, and experienced.
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