Advanced airway management

Summary of changes

  • Remove LMA's with inflatable cuffs from procedure
  • Addition section: Cricothyroidotomy with trochar kit
  • Patient positioning for Needle cricothyroidotomy, Cricothyroidotomy with trochar kit, Cricothyroidotomy with scalpel
  • Advice on appropriate depth of insertion of tube through the cricoid - to avoid left lung collapse from inserting too deep
  • Delete advise to apply disinfectant if time permits
  • Direction as to where the operator should stand and best hand position for each of the three surgical airway techniques described: Needle cricoidotomy, Cricoidotomy with Trochar, and Cricoidotomy with scalpel

Primary references

  1. Australian and New Zealand Committee on Resuscitation (2019) ANZCOR Guideline 11.1 – Introduction to and Principles of In-hospital Resuscitation, The ARC Guidelines, accessed 11 January 2022.

  2. Australian and New Zealand Committee on Resuscitation (2018) ANZCOR Guideline 11.2 – Protocols for Adult Advanced Life Support, The ARC Guidelines, accessed 11 January 2022.

  3. Cook T and Howes B (2011) 'Supraglottic airway devices: recent advances', Continuing Education in Anaesthesia Critical Care & Pain, 11(2):56–61, doi:10.1093/bjaceaccp/mkq058

  4. Cook TM and Kelly FE (2015) 'Time to abandon the 'vintage' laryngeal mask airway and adopt second-generation supraglottic airway devices as first choice', British Journal of Anaesthesia, 115(4):497-9, doi:10.1093/bja/aev156

  5. Coté CJ and Hartnick CJ (2009) 'Pediatric transtracheal and cricothyrotomy airway devices for emergency use: which are appropriate for infants and children?', Paediatric Anaesthesia, 19(Suppl 1):66-76, doi:10.1111/j.1460-9592.2009.02996.x

  6. Difficult Airway Society, Intensive Care Society, Faculty of Intensive Care Medicine and Royal College of Anaesthetists (2018) 'Guidelines for the management of tracheal intubation in critically ill adults', British Journal of Anaesthesia, 120(2):323-352, doi:10.1016/j.bja.2017.10.021

  7. Duggan LV, Ballantyne Scott B, Law JA, Morris IR, Murphy MF and Griesdale DE (2016) 'Transtracheal jet ventilation in the 'can't intubate can't oxygenate' emergency: a systematic review', British Journal of Anaesthesia, 117 (Suppl 1):i28-i38, doi:10.1093/bja/aew192

  8. Price TM and McCoy EP (2019) 'Emergency front of neck access in airway management', British Journal of Anaesthesia, 19(8):246-253, doi:10.1016/j.bjae.2019.04.002