Table Of ContentPrinciples of Airway Management
Brendan T. Finucane Ban C.H. Tsui
●
Albert H. Santora
Principles of Airway
Management
Brendan T. Finucane, MBBCh, FRCPC Ban C.H. Tsui, Dip Eng, BSc(Math),
Professor Emeritus B Pharm, MD, MSc, FRCPC
Department of Anesthesiology and Pain Professor
Medicine Department of Anesthesiology
University of Alberta and Pain Medicine
Director of Anesthesia Services Cross Director, Regional Anesthesia
Cancer Institute and Acute Pain Service
Edmonton, Alberta, Canada Stollery Children’s Hospital
Staff Anesthesiologist Leduc Community University of Alberta Hospital
Hospital Edmonton, Alberta, Canada
Leduc, Alberta, Canada
Albert H. Santora, MD
Athens, GA USA
ISBN 978-0-387-09557-8 e-ISBN 978-0-387-09558-5
DOI 10.1007/978-0-387-09558-5
Springer New York Dordrecht Heidelberg London
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Preface
By the time this edition is published, close to 23 years will have passed since
Principles of Airway Management was first published. A lot of water has passed
under the bridge since 1988. Airway groups have been formed in many countries.
Several books on the topic of airway management have been published. We now
have several algorithms to choose from when confronted with airway challenges.
A vast array of airway devices have been invented and the number of publications
on airway-related topics has increased exponentially. In 1988, none of us believed
that laryngoscopy and endotracheal intubation would be obsolete in 25 years, and of
course we were correct. However, that may not be true 25 years from now, and the
discussions about that issue are already taking place.
We have seen a decrease in the incidence of airway tragedies in the United States
in recent years, judging by the declining number of Closed Claims cases involving
the airway. Perhaps this decline occurred because we have better equipment and
better ways of detecting and managing airway problems. Perhaps the introduction
of the LMA and other supraglottic devices has had some influence on these num-
bers. However, despite the advances we have made, we continue to have our prob-
lems, and there is no room for complacency.
When we first published this book, our intended audience was medical students.
We have since expanded the scope of the book to provide a reference for a much
broader readership. This book should now appeal to any physician or nonphysician
who has a primary interest in airway management.
What is so special about this edition? We have made a number of changes, many
of which were based on the critiques of the previous edition. Most of the illustra-
tions in this edition have been redrawn and are in color. We have also added two
new chapters, making this edition more comprehensive. This edition will also be
presented in both hard and soft cover. Last, but not the least, we have recruited Ban
Tsui MD, a known expert in pediatric airway management, to join us as a new
coauthor and share with us his knowledge of the airway.
Each of the three authors has written five chapters of the book. Below is a
summary of how each author contributed to enhance this edition. Dr. Finucane
updated the opening chapters entitled “Anatomy of the Airway and Evaluation of
the Airway,” to both of which he added new and colorized illustrations and
improved content. Dr. Finucane also wrote the chapters on “Indications and
v
vi Preface
Preparation,” and “Techniques of Intubation,” and finally he wrote the closing
chapter, entitled “Complications of Airway Management,” which includes statis-
tics on airway complications from around the world. All of these chapters were
rewritten in some fashion, have many new illustrations, and have updated
bibliographies.
Dr. Tsui wrote the chapters on “Basic Emergency Airway Management and
Cardiopulmonary Resuscitation (CPR)” and “Basic Airway Equipment,” incorpo-
rating many components of the previous edition, but placing stronger emphasis on
the importance of bag/valve/mask ventilation technique and maintaining sterility of
equipment. Dr. Tsui also wrote the chapter on “Advanced Airway Devices.” In that
chapter he provides a comprehensive overview, using the most up-to-date informa-
tion on numerous airway devices now available for use, embellishing his descrip-
tions with numerous illustrations. For “The Difficult Airway” chapter, Dr. Tsui not
only updated the practice guidelines from the American Society of Anesthesiologists,
but also greatly expanded the scope of the chapter to discuss the circumstances and
management of the difficult airway in the emergency room, the intensive care unit,
and the operating room. He also stresses the importance of airway management in
obese patients and in those with obstructive sleep apnea syndrome. Finally, Dr. Tsui
has completed a major revision of the chapter dedicated to “Pediatric Airway
Management.” He divided this chapter into two sections A and B. In section A,
Dr. Tsui updated information from the previous edition on basic and advanced
airway management in the child and added some information on intubation trauma
and the use of heliox in pediatric airway management. Dr. Tsui also discusses the
important interplay between the larynx, the pharynx, and the tongue in pediatric
airway obstruction. For section B, Dr. Tsui invited Dr. Hamdy El-Hakim [MD,
FRCS(ORL-HNS), Divisions of Otolaryngology and Pediatric Surgery, Department
of Surgery, University of Alberta, Edmonton, Alberta, Canada] as a primary author
to share his expertise on surgical aspects of pediatric airway management. Drs. Tsui
and El-Hakim highlight important considerations for the anesthesiologist and sur-
geon during otolaryngological (primarily endoscopic) procedures. We are grateful
for Dr. El-Hakim’s important contribution to this chapter. This contribution by
Dr. El-Hakim is an excellent example of the importance of collaboration between
anesthesiologists and surgeons when dealing with some of the most challenging
airway issues in medicine
Dr. Santora updated chapters on “Fibroptically Guided Airway Intubation
Techniques,” “Mechanical Ventilation and Respiratory Care,” and the “Surgical
Options in Airway Management.” A new chapter, “Extubation Strategies: The
Extubation Algorithm,” addresses an area of airway management hitherto relegated
to secondary concern. Finally, the chapter entitled “The Laryngeal Mask Airway
(LMA™) and other Extraglottic (Supraglottic) Airway Devices” summarizes many
new considerations of this revolutionary airway tool. To address valid criticisms
leveled at this chapter in the 3rd Edition, extensive thought has been given to the
question: Is the extraglottic airway device interchangeable with the endotracheal
tube in the practice of anesthesia?
Preface vii
It is evident that we have completed a major revision of Principles of Airway
Management and have every hope that this edition represents the most up-to-date
information on this rapidly advancing discipline.
Edmonton, AB Brendan T. Finucane
Edmonton, AB Ban C.H. Tsui
Athens, GA Albert H. Santora
Acknowledgements
The authors wish to acknowledge Donna Finucane’s valuable contribution as we
prepared to submit the final edition to the Publisher. We would also like to give
credit to Jennifer Pillay for her contributions towards editing a portion of this book.
We would also like to thank Brian Belval for helping us get started and Catherine
Paduani for helping us finish this important edition. We are grateful to Portia
Bridges for centrally coordinating all aspects of this work at a very early stage. We
would like to thank the graphic artist Alice Chen for her excellent drawings and for
the color version of some of our old drawings. Adam Dryden helped by taking
many of the pictures of equipment and devices, and Nicole Stalker helped obtain
numerous images for the Advanced Airway Devices chapter. Finally, we would like
to acknowledge Jenkin Tsui’s drawings which helped the graphic artist interpret
what was required in some of the illustrations.
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Description:Principles of Airway Management is the leading text on the essentials of airway management. First published in 1988 and now in its Fourth Edition, it remains the text of choice for clinicians and trainees across a range of specialties – anesthesiology, emergency medicine, critical care medicine, s
