Difficult Airway: The Aftermath

| August 4, 2013 | 5 Comments

Having a “difficult airway” is a very serious thing. Depending on the type and extent of problems associated with the airway, the situation could turn into a life-threatening one (should this person need anesthesia again).

If you have ever been told you are a difficult airway, or a difficult intubation, it’s extremely important to gather all possible information about your airway from your anesthesiologist.

In order to standardize this process, the Anesthesia Patent Safety Foundation has developed a standard letter that can be filled out by your anesthesiologist. This letter explains to you (and any future anesthesia providers) exactly what occurred in managing your airway.

It’s a good idea to have multiple copies of this letter. Perhaps you can keep one yourself, give one to your primary physician, and place another in your medical record.

Some patients even get a safety alert bracelet, or carry a card in their wallet, explaining this very important part of their medical history.

Because the APSF has done a great job creating this difficult airway document, we saw no need to create our own version of the letter.

Here it is for you to download:

Difficult Intubation Letter

Have you been told you are a difficult airway? Please share your experience below.

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Category: Anesthesia Topics, General Anesthesia, operating room

Comments (5)

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  1. Amy says:

    Just got home from NOT getting laparoscopic surgery today as planned. I have to have my gallbladder removed due to having gallstones and recently Acute Pancreatitus. Got prep for surgery and off to operating room then put under. Then woke up and no surgery! They were unable to get tube through my airway. They said this is rare and now I have rescheduled my surgery at the hospital. I have had laproscoptic surgery before 5 years ago for umbilical hernia repair and no problem then. I am frustrated with a sore throat and confused about what happened! What should I expect at the hospital so this won’t happen again? Thanks Amy

    • David Draghinas says:

      Thanks for your comment, Amy. I’m sorry to hear about your experience.

      What happens the next time will ultimately be up to the anesthesiologist taking care of you. But after taking everything into consideration, he/she may choose an “awake” fiberoptic intubation. If this is the case, you may be given some sedation but be kept breathing spontaneously until the breathing tube is placed. This is done in order to be as safe as possible while the breathing tube is placed.

      It would be a good idea to print out that difficult intubation letter on this post and have your last anesthesiologist fill it out. This will give you more information on exactly what happened, and will be INVALUABLE information for any future anesthesiologists taking care of you.

      This information should be treated similar to an allergy. If you need any kind of anesthesia in the future, you need to let them know you are a difficult intubation.

      All the best with your surgery. You are in our thoughts and prayers. Please come back and update us after your surgery.

      Dr. Dave

      • Amy says:

        Thank you : ) I will take your advice and make sure everyone knows about my difficult intubation and have it on my medical record. Just still confused because about 5 years ago I had surgery to repair a umbilical hernia and there was no problem with intubation. My surgery is scheduled at the hospital April 10th. I will let you know how everything goes!

        • David Draghinas says:

          I can’t say for sure why there were no anesthesia problems five years ago. Things can change anatomically over that time, making the airway more challenging. You could have been a challenging airway back then too, but the anesthesiologist could have gotten “lucky” with the intubation.

          It’s impossible to say for sure without being there or speaking with those anesthesia providers.

          Best of luck this next time around.

          Dr. Dave

  2. Hado Harkins says:

    I went in Monday for a mastectomy was on the operating table woke up to an anesthesiologist trying to shove something down my throat and squirting horrible liquid. I kept saying that I couldn’t breathe they said I could. My brain said I understood since I was talking but my nose was clogged and they kept putting oxygen in my nose and as the tube was going down with the liquid I could not breathe. I kept thinking I can hold my breath until I felt my life slipping away. I felt like I was drowning. I stared fighting and pulled everything out. I had no way to communicate that I could not breathe from my nose. I have had 4 endoscopy done with no issues. 2 of them awake. They kept saying that I was ” juicy” this was the 3rd attempt. I don’t know why I was brought out of being asleep. My throat hurts so bad my lips are so very swollen. They have me rescheduled for next week. Having a mastectomy is so scary now I am terrified of the being under. They are going to do an awake intubation. What happened?

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