Obstetric Difficult Airway Guidelines Decision-making in Critical Situations

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Abstract

(Anaesthesia. 2015;70:1221–1229)

Anesthesiologists are frequently faced with critical decision-making when complex clinical emergencies arise (eg, failed tracheal intubation in the obstetric setting). Recent decades have seen a decline in the use of general anesthesia for cesarean section across the developed world, thus reducing the likelihood of anesthesiologists facing such situations. This increases the pressure on anesthesiologists when they do face such situations as not only is the situation a rarity for them, it also tends to be reserved for women requiring the most urgent deliveries. Universal difficult airway guideline for nonobstetric, nonpediatric patients were published in 2004, and there have been algorithms to guide anesthesiologists who encounter airway emergencies, but it is only now that national obstetric-specific difficult airway guidelines have been developed in the United Kingdom. These guidelines have been jointly developed by the Obstetric Anaesthetists’ Association (OAA) and the Difficult Airway Society (DAS). The myriad of settings in which such an airway crisis may occur and limited available evidence contributed to the delay that occurred in compiling obstetric-specific difficult airway guidelines.

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