Management of Emergency Airway : General Statement

Abstract

This section provides an overview of emergency airway management, focusing on the conditions that lead to airway emergencies, necessary equipment, and anesthesia considerations. For otolaryngologists and head and neck surgeons, upper airway obstruction is commonly encountered and is caused by conditions such as acute epiglottitis, anaphylactic shock, laryngeal edema, tumors, hemorrhaging, postoperative complications, airway foreign bodies, and trauma. A rapid assessment and stabilization of the respiratory status are crucial to prevent catastrophic outcomes. Therefore, it is essential to mentally simulate various scenarios during non-emergent times and ensure the readiness of the necessary equipment and anesthesia techniques for actual procedures. The equipment typically includes oxygen systems, bag valve masks, laryngeal masks, endotracheal tubes, cricothyroidotomy kits, and tracheostomy sets. When human resources are available, collaboration between anesthesiologists and emergency physicians is advisable. Special caution is required when performing rapid sequence intubation, particularly in cases involving post-operative bleeding or extensive neck surgery with resultant airway edema, as these situations may lead to a “cannot ventilate, cannot intubate” scenario. Airway emergencies are inseparable from our practices. Maintaining a mindset of preparedness is essential for preventing the loss of lives that could otherwise be saved.