Airway Management in out of the Operating Room Environments
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AIRWAY MANAGEMENT (LC BERKOW, SECTION EDITOR)
Airway Management in out of the Operating Room Environments Shahehaz Elsamragy 1
&
Tarini Vats 2 & Irene Osborn 3
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review This review explores the expanding considerations and techniques for airway management of patients in remote settings outside of the operating room (OR). These environments bring various challenges for the patient as well as practitioner and it is essential to proceed safely. Recent Findings New developments in patient monitoring, oxygen delivery, and airway adjuncts have provided solutions to the many challenges involved in management of the airway in remote environments. These devices and techniques may have had their origins in the operating room but are uniquely applicable to outside locations. Currently, few studies are available but clinical experience is leading the way. Summary Diagnostic and therapeutic procedures in remote locations constitute a significant portion of anesthetic care that is required increasingly for patient management. Given the frequent number of complex patients involved, it becomes necessary to employ the safest and most efficient techniques to accomplish these goals. The goals for airway management continue to be oxygenation and ventilation with the protection from gastric aspiration when at risk. Keywords Intubation . Supra-glottic airway . Non-OR anesthesia . High-flow nasal oxygenation . Airway obstruction . Jaw elevation device
Introduction Airway management is an essential part of anesthetic practice and continues to evolve with the advances in medicine. Anesthesia providers must consider three aspects: (1) effective oxygenation and ventilation; (2) prevention of pulmonary aspiration; and (3) ability to control and instrument the airway when This article is part of the Topical Collection on Airway Management * Shahehaz Elsamragy [email protected] Tarini Vats [email protected] Irene Osborn [email protected] 1
Albert Einstein/Montefiore Medical Center, 111 E. 210th Street Bronx, New York, NY 10464, USA
2
Albert Einstein College of Medicine, 111 E. 210th Street Bronx, New York, NY 10464, USA
3
Division of Neuroanesthesia Albert Einstein/Montefiore Medical Center, Department of Anesthesiology, 111 E. 210th Street Bronx, New York, NY 10464, USA
needed. These goals are often clear in the operating room, where a surgical procedure, patient position, and airway exam dictate the approach to airway control. In addition, all anesthetics are conducted with required basic monitoring that includes ECG, pulse oximetry, capnography, and blood pressure measurement [1]. The management of patients is facilitated by the fact that they are usually within arm’s length of the provider and can be easily observed and problems addressed. A different situation exists when sedation and/or anesthesia is provided outside of the OR where the anesthesiologist is faced with a unique set of challenges that can be summarized, as follo
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