Airway Emergencies - failed ventilation, failed intubation
Anaesthetized patient who cannot be ventilated or intubated

* Laryngeal mask airway
* Combitube
* Transtracheal jet ventilation
* Surgical airway
cricothryotomy, minitracheostomy, tracheostomy

Improve Ability to Ventilate

* Better patient positioning
* Jaw thrust
* Guedel airway
* Nasopharyngeal (although run risk of producing bleeding in already difficult situation)
* Apply mask with two hands and give reservoir bag to assistant
* Laryngeal mask (LM) or Intubating laryngeal mask (ILM)
* Surgical Airway

DIFFICULT MASK VENTILATION Try:

* appropriately sized face mask
* oropharyngeal & nasopharyngeal airways
* holding mask with both hands, 2nd person to squeeze reservoir bag
* high fresh gas flow +/- continuous application of oxygen flush

POOR LARYNGOSCOPIC VIEW Consider:

* release of cricoid pressure (may be distorting view)
* come out & re-position patient
* use of gum elastic bougie
* alternate laryngoscope (eg Bullard) or blade (eg different size, McCoy or straight)
* fibreoptic intubation if skilled

Difficult ventilation & failed intubation:

* LMA (more people are familiar with this)
* Combitube
* Both can be inserted blindly to establish an airway

CAN’T VENTILATE, CAN’T INTUBATE
# Direct route into airway must be established: Cricothyroidotomy
# Tracheostomy