Obstetric Airway Management
Oct 06, 2023![](https://kajabi-storefronts-production.kajabi-cdn.com/kajabi-storefronts-production/file-uploads/blogs/2147545446/images/d2143d0-e50-df3b-5df7-2dab78d3227_Concept_Series_website_YouTube_Banner_.png)
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/