Multiple airways. Rapid assessment is key for managing numerous patients.

JEMS

Department of Emergency Medicine and Anesthesiology, University of Pittsburgh School of Medicine, USA.

Published: May 2012

Encountering a situation that necessitates the assessment and management of patients requiring airway management can present a significant challenge. It will require a different thought process and set of decision-making skills that vary from the routine practice of airway management during a single patient encounter. Rapid triaging of the need for airway management is important. Creating a categorization of those patients who simply need supplemental oxygen from those who require assistance with the mechanical opening of the airway, a need for positive-pressure ventilation and those who require protection from aspiration can be a useful starting place for the creation of a treatment plan. Treatment decisions will depend on the amount of equipment and personnel resources that are available. Non-traditional decision procedures and positioning may need to be implemented, such as placing patients in a lateral recumbent position to use gravity to assist in keeping the airway patent. In the setting of multiple patient encounters requiring airway management, it's important to consider the length of time each procedure will take and the amount of equipment that will be required. A rapid securing of the airway by a supraglottic device in suitable patients may be favored over traditional approaches of ETI secondary to the relative complexity of the procedure.

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