Internet Journal of Airway Management



Volume 5 (January 2008 to December 2009)


Zadrobilek E, Krasser K, Puchner W, Missaghi SM, Marian F (for the Austrian Working Group for Airway Management). Recommendations of the Austrian Working Group for Airway Management: Strategies for the Management of the Unanticipated Difficult Airway

Training of Alternative Airway Management Techniques



Strategies for the management of the difficult airway (DA) should be regularly practiced on selected patients (22, 43). The strict adherence to a preformulated plan and trained personnel have shown to be effective in solving most of the problems associated with DA management (31). Therefore, continued training of the evaluated alternative airway management (AM) techniques, including all team members, is needed to be prepared for mastering DA situations.


AM techniques that are considered safe for routine patient care, such as flexible bronchoscopy-assisted tracheal intubation techniques, can be used for training purposes without obtaining specific patient consent, provided that an experienced instructor is present when performed by less experienced operators. Percutaneous transtracheal catheter insertion and percutaneous cricothyrotomy, techniques used only in extreme and desperate emergency situations, should be learned and practiced on suitable airway models.       


Recommendations of the Austrian Working Group for Airway Management


We recommend regular training of evaluated alternative AM techniques on selected patients to gain and maintain the necessary skills for the management of DA situations. We further emphasize learning and practice of invasive AM techniques on suitable models.    



Follow-Up Care of Patients Following a Difficult Tracheal Intubation

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