Nutbeam et al. stated that ‘broadly speaking, there are four modes of managing the airway: facemask; supraglottic airway device; tracheal tube and direct access to the trachea’ , reflecting the latest guidelines from the American Society of Anesthesiologists and the Difficult Airway Society . Although anatomically correct, we suggest that a fifth way of oxygenating the patient should not be forgotten by anaesthetists and guideline writers.Sheridan et al. first described an extracorporeal membrane oxygenation technique in a paediatric patient with a difficult airway in 2008, which was used after the currently recognised four modes of airway management failed . Holliday and Jackson reported similar, successful use in an emergency airway obstruction management in 2010 , as did Willms et al. in 2012, in a case of total distal tracheal stent obstruction by tumour mass .ReferencesNutbeam T, Clarke R, Luff T, Enki D, Gay D. The height of the cricothyroid membrane on computed tomography scans in trauma patients. Anaesthesia 2017; 72: 987–92.Apfelbaum JL, Hagberg CA, Caplan RA, et al. Practice guidelines for management of the difficult airway: an updated report by the american society of anesthesiologists task force on management of the difficult airway. Anesthesiology 2013; 118: 251–70.Frerk C, Mitchell VS, McNarry AF, et al.
Anaesthesia – Wiley
Published: Jan 1, 2018
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