2–5Ĭriteria for literature acceptance included randomized controlled trials, prospective nonrandomized comparative studies ( e.g., quasiexperimental, cohort), retrospective comparative studies ( e.g., case control), observational studies ( e.g., correlational or descriptive statistics), and case reports or case series from peer-reviewed journals. Preparation of these updated guidelines followed a rigorous methodologic process, described in more detail in appendix 2 and other related publications. A summary of recommendations is provided in appendix 1. Sixth, all available information was used to build consensus to finalize the Guidelines. Fifth, additional opinions were solicited from random samples of active members of the ASA and participating organizations. Fourth, consultants who had expertise or interest in difficult airway management and who practiced or worked in various settings ( e.g., private and academic practice) were asked to participate in opinion surveys addressing the appropriateness, completeness, and feasibility of implementation of the draft recommendations and to review and comment on a draft of the guidelines. Third, original published articles from peer-reviewed journals relevant to difficult airway management were evaluated and added to literature included in the previous update. Second, a comprehensive literature search was conducted by an independent librarian to identify citations relevant to the evidence criteria. First, consensus was reached on the criteria for evidence. These updated guidelines were developed by means of a six-step process. Provide new algorithms and infographics for adult and pediatric difficult airway management. Provide more robust recommendations for extubation of the difficult airway. Offer noninvasive and invasive alternatives for difficult airway management.Įmphasize awareness of the passage of time and limiting the number of attempts of different devices and techniques during difficult airway management. Recommend supplemental oxygen administration before initiating and throughout difficult airway management, including the extubation process. Update equipment for standard and advanced difficult airway management. Provide consideration for the development of a difficult airway management strategy including considerations for awake airway management. Provide new evidence obtained from recent scientific literature along with findings from new surveys of expert consultants, American Society of Anesthesiologists members, and 10 participating organizations. The guidelines do not address education, training, or certification requirements for practitioners who provide anesthesia and airway management.ĭiffer from previous guidelines in that they were developed by an international task force of anesthesiologists representing several anesthesiology, airway, and other medical organizations. Specifically address difficult airway management. Replace the “Practice Guidelines for Management of the Difficult Airway: A Report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway,” adopted by the American Society of Anesthesiologists in 2012 and published in 2013.
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