Difficult Airway Algorithm

24 Sep

Heard AM, Green RJ, Eakins P.

  • Australian anesthesiologists designed an evidence-based difficult airway algorithm and trained their staff in its procedures
  • Training included 1hr “dry lab” using mannequins, plus a “wet lab” using intubated sheep who were being euthanized for medical research

  • First step is always needle cric, because:
    • it is easy to remember,
    • the required equipment is readily accessible,
    • and is a temporizing measure
  • All pathways involve middle step of jet ventilation and stabilization
  • All endpoints involve a cuffed endotracheal device


  • Scalpel bougie and neck dissection had the highest success rates (100%).
  • Scalpel bougie was the quickest (39 seconds mean). They observed thousands of these procedures but only reported success rates and time to successful completion for 10.
  • Scalpel bougie is most useful for airways when air cannot be aspirated with needle cric (ie bloody) but external anatomy is still palpable.
  • Melker is their favorite Seldinger technique airway device when compared with 3 others

Submitted by M. Smith.


Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )


Connecting to %s

%d bloggers like this: