airway cart while the anesthesia provider focuses on the patient and
other staff members assist as needed. Members of the care team
should also feel empowered to speak up if they have a concern about
the patient's airway. That's true of most safety initiatives, but it's espe-
cially important when airways could be compromised. Providers
shouldn't repeat the same technique while trying to manage a difficult
airway because repeated intubation attempts could create serious
problems such as swelling or bleeding. That's why it's important for
staff to feel comfortable stepping in to suggest switching to airway
management plan B or C, which providers should have considered
and discussed with the team before the procedure.
An important reminder: Extubation is a critical point of care, but
anesthesia providers and surgical team members sometimes lose
focus on securing the airway as they complete charting, clean the
room and turn their attention to the next case. But be aware that air-
way complications, such as laryngospasms, can occur when airway
devices are removed. The end of surgery is not the time to ignore
the importance of proper airway management.
OSM
J U L Y 2 0 1 8 • O U T PA T I E N TS U R G E R Y. N E T • 1 5
Check out the latest Practice Guidelines for
Management of the Difficult Airway from the
American Society of Anesthesiologists for more
information about what should be in your air-
way cart and how to prepare for intubation
emergencies: osmag.net/tyTC3V
On the Web
Dr. Hagberg (chagberg@mdanderson.org) is the Helen Shaffer Fly distin-
guished professor of anesthesiology and division head of anesthesiology, critical
care and pain medicine at the University of Texas MD Anderson Cancer Center
in Houston.
