Airway Assessment

Excerpt

A thorough but brief airway assessment is essential for patients requiring advanced airway management. Indications for airway management are a failure to oxygenate, ventilate, or maintain a patent airway. The modality of airway management primarily depends on the cause and severity of the patient's condition but is also subject to environmental factors and clinician skills.

Airway management is performed through the utilization of both noninvasive and invasive techniques. Noninvasive airway management includes passive oxygenation, bag-valve-mask ventilation, supraglottic airways, and noninvasive positive-pressure ventilation. Invasive airway management comprises advanced skills such as endotracheal intubation, cricothyroidotomy, and tracheostomy.

A patient needing airway management requires assessment for a difficult airway. A difficult airway may prohibit mask ventilation or increase the risk of a failed intubation attempt. A failed airway is defined as three unsuccessful attempts at intubation by an experienced practitioner.

Obtaining an airway-specific history from the patient aids in determining if there has been a previous airway problem. Many disease states have been associated with a difficult airway. In addition, pulmonary pathologies such as asthma, pneumonia, and chronic obstructive pulmonary disease may affect oxygenation and ventilation.