Emergent Airway Management: an Update

Medical patients need emergent airway management sometimes. The clinical instability leads to "physiologically" difficult airway and subsequent morbidity and mortality. Human factors, technique, devices, and environment all contribute to successful airway management. Adequate training, team working, and pre-procedural planning including rescue interventions may prevent complications. Optimal preoxygenation could be achieved by applying mask ventilation and high-flow nasal cannula. Video laryngoscope and bougie may facilitate endotracheal intubation. When intubation attempts fail, face mask ventilation or supraglottic airway are alternatives to maintain oxygenation. A front-of-neck airway should be performed when 'can't intubate, can't oxygenate' situation occurs. Meticulous peri-intubation care including intensive hemodynamic monitoring and adequate positioning and maintenance of the established airway is essential to prevent complications.