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Book and Media Reviews |

Management of the Difficult and Failed Airway

Bryan Maxwell, MD, MPH, Reviewer; Alex Macario, MD, MBA, Reviewer
JAMA. 2008;300(7):850-851. doi:10.1001/jama.300.7.jbk0820-b.
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Published online

Extract

Imagine going to work every day knowing that you may have to confront a difficult airway. The airway is really just a conduit for gas exchange: oxygen in, carbon dioxide out. When airway management goes well, that too seems incredibly simple. But when it goes badly, things can become complex and daunting.

As the authors of Management of the Difficult and Failed Airway remind their readers, despite decades of study, and even with the application of multiple criteria, there is no 100% sensitive and specific way of determining ahead of time which patients will develop a failed airway—defined as 3 unsuccessful attempts at tracheal intubation, the inability to keep oxygen saturation above 90%, or both. Unlike many other puzzles and challenges in an environment of increasingly digital practice, an airway emergency does not allow the luxury of as-needed consultation of a reference book, even if such a book were on one's hip in electronic form. The proper care of the patient with failed airway requires having detailed medical knowledge as well as the judgment and poise to go to a plan B or even a plan C if necessary.

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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