The Difficult Airway

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Advantages & Disadvantages

 

Advantages

Disadvantages

Bag Valve Mask

Quick and Easy

Does not prevent aspiration

MacIntosh Blade

Effective

Difficult with large tongue, small mouths

Miller Blade

Effective

May cause more airway trauma than Mac

Nasal intubation

More tolerable for awake patients

Bleeding, must be breathing, not for use in facial fractures

Digital intubation

Fast, easy, no tools required

Rescuer may get bitten

Retrograde intubation

Does not move neck

Invasive

King LTD / LTSD

Quick and easy, no c-spine manipulation

Size variations based on patient anatomy / size

Laryngeal Mask Airway

Easy, little cervical movement

Does not prevent aspiration, is not secure

Combitube

Blind, may prevent aspiration, little cervical movement

Need to choose correct port. May not form tight seal

Needle cricothyrotomy

Quick

Need high pressure to ventilate (barotrauma), invasive

Open cricothyrotomy

Definitive airway

Most invasive, most training needed

Video Laryngoscope

Direct vizualization; good for difficult airways

Cost, training and limited adult sizes



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