Acute Care MedicineAirway MedicalCritical CareResuscitationSMACCConfined Space Airway Management in Emergency and Critical Care

Confined Space Airway Management in Emergency and Critical Care by Ross Hofmeyr

Ross Hofmeyr discusses the ins and outs of managing an airway in a confined space.

He details the challenges, the potential solutions and his top tips when faced with an airway in a less than ideal setting.

Ross defines confined space airway management as airway management in an environment where access to the patient, normal positioning, and use of airway equipment is limited by physical constraints.

Ultimately, these situations are endless. An icy crevasse or on a mountain top. Inside a cave. Motor vehicle crash scenes. War zones with bullets flying overhead. The inside of a helicopter or the back of an ambulance.

Even inside tight Emergency Departments, cath labs or operating rooms that are full of advanced equipment. These are all scenarios in which one may find themselves faced with confined space airway management.

Ross contends that all airway clinicians have the possibility to have to handle these situations.

In this presentation, Ross addresses the locations and difficulties which can be anticipated, and then discusses the options, techniques, and evidence available for managing airways in constrained places. Learning to cope (and then excel) in abnormal fashions and positions makes us better at managing airways in both emergency and routine situations.

Ross discusses the specific techniques, equipment and alternatives that can assist a clinician in tight situations. He backs up his thoughts with literature which demonstrates which techniques may be considered.

Moreover, his primary piece of advice to managing an airway in a confined space is, don’t do it! His first tip – get the patient out of the confined situation!

Evidently, this may not always be possible. If that is the case, Ross recommends a Supraglottic device. Otherwise, a channel laryngoscope is his next go too.

Failing that, Ross stresses that a clinician must be prepared, mentally and physically, to proceed with a surgical airway. The more skills, knowledge, and flexibility the clinician has means the better they will be able to cope with confined airway management.

Confined Space Airway Management in Emergency and Critical Care

Finally, for more like this, head to our podcast page. #CodaPodcast

Ross Hofmeyr

Critical Care/anaesthesia doc, airway & #FOAM enthusiast