Airway management in the adult patient with an unstable cervical spine.
Journal
Current opinion in anaesthesiology
ISSN: 1473-6500
Titre abrégé: Curr Opin Anaesthesiol
Pays: United States
ID NLM: 8813436
Informations de publication
Date de publication:
01 Oct 2021
01 Oct 2021
Historique:
pubmed:
30
7
2021
medline:
28
8
2021
entrez:
29
7
2021
Statut:
ppublish
Résumé
The ideal airway management of patients with unstable spinal injury presents a perennial challenge for anaesthesiologists. With competing interests, potentially catastrophic complications, and a scarcity of evidence to support common practices, it is an area rich with dogma and devoid of data. This review seeks to highlight recent evidence that improves our assurance that what we do to manage the airway in the unstable cervical spine is supported by data. The increasing range of available technology for intubation provides important opportunities to investigate the superiority (or otherwise) of various techniques - and a chance to challenge accepted practice. Long-held assumptions regarding spinal immobilisation in the context of airway management may require refinement as a true base of evidence develops. Video laryngoscopy may replace direct laryngoscopy as the default technique for endotracheal intubation in patients with suspected or confirmed spinal instability. Immobilisation of the unstable cervical spine, manually or with rigid cervical collars, is increasingly controversial. It may be that hard collars are used in specific circumstances, rather than as universal precaution in the future.There are no recent data of significantly high quality to warrant wholesale changes to recommended airway management practice and in the absence of new information, limiting movement (in the suspected or confirmed unstable cervical spine) remains the mainstay of clinical practice advice.
Identifiants
pubmed: 34325462
doi: 10.1097/ACO.0000000000001040
pii: 00001503-202110000-00009
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
597-602Informations de copyright
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
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