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MANAGEMENT OF THE DIFFICULT AIRWAY



Easing endotracheal intubation is necessary in the patient who is awake and in the patient who has increased intracranial pressure, for example. Blocking sensation to the larynx will not only make the intubation more comfortable but also, inihibit reflexes that increase the intracranial pressure.

Any difficult intubation is also aided by these techniques. Most of these techniques, however, are not done by all physicians and an anesthesiologist or similarly-trained physician must frequently intervene.

TECHNIQUES TO EASE INTUBATION IN THE AWAKE PATIENT:

SUPERIOR LARYNGEAL NERVE BLOCK
GLOSSOPHARYNGEAL NERVE (GAG) BLOCK
TRANSTRACHEAL BLOCK
RETROGRADE INTUBATION
FIBEROPTIC INTUBATION
INTUBATION WITH SEDATION AND NEUROMUSCULAR BLOCKADE

Choice of sedatives in various clinical situations
Choice of neuromuscular blockers in various clinical situations

If else fails, one should perform tracheostomy



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