emDocs - June 19, 2016 - Authors: Bucher J and Cuthbert D
Edited by: Santistevan J, Koyfman A and Long B
"It is vital that emergency physicians are exceedingly skilled at airway management while caring for critical patients in the emergency department (ED). This can be a daunting task due to the variation and complexity of patients that present with critical illness. Problems are frequently encountered in the process of intubation, which can potentially exacerbate a bad situation. Therefore, it is imperative that ED physicians are prepared in dealing with the complications of intubation as with the process in itself.
Current literature reports that up to 12% of intubations will require multiple attempts, leaving surviving patients at an elevated risk of adverse events later on.1 In this post, we will review a case that demonstrates some of the common problems that lead to unsuccessful first-pass intubation attempts. We will then discuss 5 common procedural intubation complications that lead to a failure in proper and timely airway management. A discussion of how to prevent such difficulties while preparing to manage their consequences is provided.
- Error 1: Failure to appropriately evaluate the airway
- Error 2: Failure of positioning of the airway
- Error 3: Failure to prepare a backup plan
- Error 4: Failure to select appropriate methods and medications
- Error 5: Failure of decision-making"