Challenges of Emergency Airway Management

Emergency airway management often involves a combination of factors that increase the technical difficulty of intubation and increase patient risk. These factors include:

1. Dynamically deteriorating clinical situation, i.e., there is a real “need for speed”
2. Non-cooperative patient
3. Respiratory and ventilatory compromise
4. Impaired oxygenation
5. Full stomach (increased risk of regurgitation, vomiting, aspiration)
6. Extremely short safe apnea times
7. Secretions, blood, vomitus, and distorted anatomy

Safe practice requires a rapid assessment of the patient’s clinical status and potential life-threat, coupled with an understanding of the risks and benefits of rapid sequence intubation and other airway techniques. Finally, the clinician must have the equipment and skills needed to ventilate and intubate the patient quickly.