Obstetric Airway Management

airway management difficult airway education obstetrics anaesthesia patient safety safety Oct 06, 2023

The obstetric airway is usually more difficult, but should not be feared. 🤰🏼🙌🏻 The anaesthetic nurse is crucial to safe obstetric airway management.

Why is it more difficult? 🤷🏽‍♀️ 3 reasons:

➡️ Laryngoscopy is more difficult
👉🏻Insertion of laryngoscope can be challenging and view of larynx is usually 1-2 grades worse at term
👉🏻Airway mucosa is oedematous
➡️ Safe apnoea time is short
👉🏻The oxygen reservoir is much smaller
👉🏻The oxygen demand is much higher
➡️ Aspiration risk
👉🏻All pregnant patients are an aspiration risk due to functional reflux and delayed gastric emptying.

Putting this all together, here is what the anaesthetic nurse needs to know:

✅ Always be prepared for a GA during caesarean section, even with the “simple” cases.
✅ Position the patient well & preoxygenate effectively
✅ A rapid sequence induction is standard practice, so grab a colleague if that’s your normal practice.
✅ Have a videolaryngoscope and bougie ready as Plan A
✅ Remember to use a shared mental model (such as the vortex approach)
👉🏻Oxygenation is the priority
👉🏻Optimise each lifeline quickly
👉🏻Limit the number of attempts at each lifeline to 3
👉🏻Escalate CICO status as each lifeline fails

Now you’re ready to manage the obstetric airway!

Build knowledge ✅
Improve safety ✅

For more information about GA caesarean, preoxygenation, safe apnoea time, rapid sequence induction and optimising lifelines, check out our other Concept Series articles. 


Ref: https://resources.wfsahq.org/atotw/obstetric-airway-management/

Want to keep learning?

Want more content like this? Check out our premium membership for exclusive content. 

Click Here for Access

 

 

Join our mailing list for free weekly educational content.

 

By entering your details you consent to receiving amazing educational materials and updates about our products and events.