Quick Answer
Advanced airway techniques are appropriate when a patient's airway is compromised and cannot be managed with basic airway maneuvers, such as bag-valve-mask ventilation. This is often indicated by signs of inadequate oxygenation, such as cyanosis, or difficulty with ventilation. A patient who requires advanced airway management should have a rapid sequence intubation or be placed on a mechanical ventilator.
Indications for Advanced Airway Management
Advanced airway management may be necessary in cases of severe head trauma, where a patient is at risk for aspiration, or in patients with severe respiratory distress. In these situations, the ability to secure a patient’s airway with an endotracheal tube or laryngeal mask airway (LMA) is crucial. A patient who requires a rapid sequence intubation (RSI) should have a secure IV line in place and be adequately paralyzed with neuromuscular blocking agents, such as succinylcholine, to prevent movement during the procedure.
Techniques for Advanced Airway Management
Advanced airway management requires a high level of skill and practice. The American Heart Association recommends that medical professionals who perform advanced airway procedures be trained in the use of laryngoscopes and endotracheal tubes, as well as the management of complications, such as esophageal intubation. A patient who is being intubated should be monitored closely for signs of hypoxia, hemodynamic instability, and other complications, and have a plan in place for emergency management. This may include the use of a portable ventilator or the administration of emergency medications, such as naloxone or epinephrine.
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