Pulmonary Medicine Expert Witness On Difficult Airways

Pulmonary medicine expert witness Kathleen S. Adams, RCP, RRT-NPS, is an instructor and owner of Packmule Education & Consulting Services in Southern California. Also the president-elect of the California Society for Respiratory Care, here she writes on difficult airways.

What constitutes a difficult airway? It is important to have an understanding of this and particularly what is causing the airway difficulties that you are experiencing in order to better understand which Plan B may be your best option. There is however, no single generally accepted definition of a difficult airway. For the purposes of its practice guidelines for the difficult airway, the American Society of Anesthesiology set a definition of a clinical situation in which a conventionally trained anesthesiologist experiences difficulty with face mask ventilation of the upper airway, difficulty with tracheal intubation, or both. The guidelines continue that an airway proven to be difficult is a combination of patient factors, the current clinical setting and the skill level of the practitioner performing the airway maneuvers.

This article appears in RT for Decision Makers Magazine March 2009.