Module 12
The American Society of Anesthesiologists'
Management
of the Difficult Airway Algorithm
and Explanation-Analysis of the Algorithm
Conclusion
 In
summary, the ASA Difficult Airway Management Algorithm has
worked well over the past decade. In fact, there has been
a very dramatic decrease (30-40%) in the number of
respiratory-related malpractice law suits, brain damage, and
deaths attributable to anesthesia since 1990 (Fig. 7).21
However, a number of issues have emerged that indicate that the
ASA Difficult Airway Management Algorithm can be improved, as
discussed in this chapter. Consideration of these issues should
make the ASA Difficult Airway Management Algorithm still more
clinically specific and functional. Nonetheless, the
algorithm provides excellent guidelines for anesthesiologists in
their clinical decision making in patients with difficult
airways. Successful management of these patients is key
for reducing the risk of anesthesia-related morbidity and
mortality.
As the practice of airway
management becomes more advanced, anesthesiolgists must become
both knowledgeable and proficient in the use of various airway
devices and techniques. Although the algorithm cannot be
practiced in its entirely on a regular basis, anesthesiolgists
need to incorporate these alternative devices and techniques
into their daily practice so they can develop the confidence and
skill required for their successful use in the emergent setting.
All of the equipment described should be available for regular
practice and a difficult airway cart or portable unit should be
located near every anesthetizing location. Finally, appropriate
follow-up and communication should be performed so that future
caretakers will not unwittingly reproduce the same experience
and risk.
|
