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Concept
Advanced airway management
Summary
Advanced airway management is the subset of airway management that involves advanced training, skill, and invasiveness. It encompasses various techniques performed to create an open or patent airway – a clear path between a patient's lungs and the outside world.
This is accomplished by clearing or preventing obstructions of airways. Obstructions can be caused by many things, including the patient's own tongue or other anatomical components of the airway, foreign bodies, excessive amounts of blood and body fluids, or aspiration of food particles.
Unlike basic airway management such as head tilt/chin lift or jaw-thrust maneuver, advanced airway management relies on the use of medical equipment and advanced training. Certain invasive airway management techniques can be performed "blind" or with visualization of the glottis. Visualization of the glottis can be accomplished either directly by using a laryngoscope blade or by utilizing newer video technology options.
In roughly increasing order of invasiveness are the use of supraglottic devices such as oropharyngeal (OPA), nasopharyngeal (NPA), and laryngeal mask airways (LMA). Laryngeal mask airways can even be used to deliver general anesthesia. These are followed by infraglottic techniques, such as tracheal intubation and finally surgical techniques.
Advanced airway management is a key component in cardiopulmonary resuscitation, anaesthesia, emergency medicine, and intensive care medicine. The A in the ABC initialism mnemonic for dealing with critically ill patients stands for airway management. Many airways are straightforward to manage. However, some can be challenging. Such difficulties can be predicted to some extent; a recent Cochrane systematic review examines the sensitivity and specificity of the various bedside tests commonly used to predict difficulty in airway management.
Pharyngeal airway devices are used in spontaneously breathing patients to move the tongue away from the back of the throat to restore airway patency.
Official source
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