Difficult Airways: Key Factors for Successful Management.

Purpose: To describe anesthetic nurses' experiences of key factors for the successful management of difficult airways in adult patients.

Design: This study had a qualitative observational and descriptive design following the critical incident technique.

Methods: Twelve experienced anesthetic nurses were interviewed.

Findings: We identified five key factors for the successful management of difficult airways: identification of the difficult airway, creating a plan of action, remaining calm and focusing on the task, technical skills, and using the equipment. Identification of the difficult airway implies preassessment with standardized methods and actively observing for signs indicative of a difficult airway. Having all equipment available at bedside during induction and creating a backup plan increases the action force in unexpected situations. A calm and methodical work procedure facilitates the management of the difficult airway as well as selecting techniques and equipment according to the patient and situation.

Conclusions: Reflective practice can aid the anesthetic nurse in drawing on experience and remaining calm in acute situations.