B-ENT

Complex intubation, cricothyrotomy and tracheotomy

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Department of Emergency Medicine, Hospital Sint Jan, Kruidtuinlaan 32, 1000 Brussels

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Department of Emergency Medicine, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium

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Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven and KU Leuven Department of Oncology Section Head and Neck Oncology, Kapucijnenvoer 33, 3000 Leuven, Belgium

4.

Department of Emergency Medicine, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Belgium

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Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem

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Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp

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Multidisciplinary Cleft Lip and Palate Team, UZ Leuven, Kapucijnenvoer 33, 3000 Leuven, Belgium

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Department of Otorhinolaryngology, Head and Neck Surgery, UZ Leuven, Belgium, Kapucijnenvoer 33, 3000 Leuven, Belgium

B-ENT 2016; 12: Supplement 103-118
Read: 562 Downloads: 459 Published: 03 February 2020

Complex intubation, cricothyrotomy and tracheotomy. Successful management of a difficult airway begins with recognizing the potential problem. When the patient cannot breathe spontaneously, oxygenation and ventilation should start first with bag-valve ventilation, with or without an airway adjunct such as a Mayo cannula, followed by an orotracheal intubation attempt, performed by an experienced emergency doctor. If orotracheal intubation fails, a quick decision must be made regarding surgical options. In a “cannot intubate, cannot ventilate” situation, a surgical cricothyrotomy should be considered. When orotracheal intubation is impossible, but bag-valve or laryngeal mask ventilation is possible, an urgent surgical tracheostomy should be performed. In the long run, patients in need of longterm artificial ventilation will need a percutaneous or open tracheostomy. This review provides an update of all aspects of immediate and long-term airway management.

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EISSN 2684-4907