Failed Intubation Attempts

• Previous message: Failed Intubation Attempts
• Next message: Failed Intubation Attempts
• Messages sorted by: [ date ] [ thread ] [ subject ] [ author ]

 
As an anesthesiologist, I am unaware of a universally accepted definition  
other than the inability to intubate after multiple attempts. This definition of 
 failure, taken from the ASA's Difficult Airway Algorithm, is useful  because 
it focuses on the end result. If it took several laryngoscopies and  
different techniques to intubate but the intubation was successful and the  patient 
survived without significant morbidity, the event would be characterized  as 
being difficult rather than a failure. 
 
Where hard numbers are incorporated into recommendations published in the  
literature, I get the feeling those numbers are there to give providers a way of 
 justifying to themselves when it's OK to change their plan and use an  
alternative approach. The hardest part of a surgical airway sometimes is making  
the decision to give-up on Plan A and pick-up the knife. 
 
 
Curt Bergstrom, MD
 
 
In a message dated 3/24/2009 3:12:21 AM West Pacific Standard Time,  
rangraj at gmail.com writes:

Keith,  the ASA guidelines and definitions are attached.Kovacs and Law in
their  text Airway Management in Emergencies  (
http://books.google.co.in/books?id=8DVZt63PRLgC&pg=PA204&lpg=PA204&dq=failed+i
ntubation+definition&source=bl&ots=tM1J18SAXA&sig=zkirx3ZjV6wWwlSv0fBIiR_EC5g&
hl=en&ei=5cHHSdjNApSM6gOx7KXBBw&sa=X&oi=book_result&resnum=3&ct=result)<http:/
/books.google.co.in/books?id=8DVZt63PRLgC&pg=PA204&lpg=PA204&dq=failed+intubat
ion+definition&source=bl&ots=tM1J18SAXA&sig=zkirx3ZjV6wWwlSv0fBIiR_EC5g&hl=en&
ei=5cHHSdjNApSM6gOx7KXBBw&sa=X&oi=book_result&resnum=3&ct=result>
mention
three  attempts as the definition of failed intubation.rangraj

On Mon, Mar 23,  2009 at 9:49 PM, Keith Lamb <lambrrt at gmail.com> wrote:

> Is  there a universally recognized guideline of what constitutes a "failed
>  intubation"? There seem to be many opinions. I have heard a couple
>  recently,
> and am interested in your opinions.
>
>  Example:
>
> 1) introduction of the laryngoscope without placement  of ET = failed
> attempt.
>
> 2) 3 introductions of scope  without placement of ET OR disrythmias/profound
> desaturations during  attempt etc etc. = failed attempt.
>
> It seems intuitive that any  attempt at placing ET without success is a
> failure. However you can  see that opinions vary and for QUALITY ASSURANCE
> purposes I am looking  for a specific definition, as to what constitutes a
> failed "attempt",  when should the intubator move to another adjunct
> approach, and when  should another intubator take over and attempt
>  intubation.
>




**************Feeling the pinch at the grocery store?  Make dinner for $10 or 
less. (http://food.aol.com/frugal-feasts?ncid=emlcntusfood00000001)

• Previous message: Failed Intubation Attempts
• Next message: Failed Intubation Attempts
• Messages sorted by: [ date ] [ thread ] [ subject ] [ author ]