3,690
edits
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impossible. The best technique will depend on the equipment and | impossible. The best technique will depend on the equipment and | ||
expertise available, as well as the nature of the difficult airway. | expertise available, as well as the nature of the difficult airway. | ||
Inhalational induction, using halothane or sevoflurane in 100% | Inhalational induction, using halothane or sevoflurane in 100% | ||
oxygen, is generally recommended Intravenous access may be | oxygen, is generally recommended Intravenous access may be | ||
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until laryngoscopy is tolerated or LMA inserted or FOI performed | until laryngoscopy is tolerated or LMA inserted or FOI performed | ||
depending on the airway management plan. | depending on the airway management plan. | ||
If inhalational induction is impossible, small doses of IV induction | If inhalational induction is impossible, small doses of IV induction | ||
agent should be given to induce loss of consciousness but still | agent should be given to induce loss of consciousness but still | ||
preserving spontaneous ventilation. Propofol 0.5-1mg.kg-1 or ketamine | preserving spontaneous ventilation. Propofol 0.5-1mg.kg-1 or ketamine | ||
0.5-1mg.kg-1 should be given and titrated to effect. | 0.5-1mg.kg-1 should be given and titrated to effect. | ||
If inhalational induction is not possible due to pain, for instance, from | If inhalational induction is not possible due to pain, for instance, from | ||
an infected facial mass/tumour (rather than because of a large extraoral | an infected facial mass/tumour (rather than because of a large extraoral | ||
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combination provides better conditions for laryngoscopy than when | combination provides better conditions for laryngoscopy than when | ||
using intravenous ketamine alone. | using intravenous ketamine alone. | ||
Nasal fibreoptic intubation – general | Nasal fibreoptic intubation – general | ||
• Maintain anaesthesia either with incremental doses of ketamine | • Maintain anaesthesia either with incremental doses of ketamine |