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from Section 1 - Nuts and Bolts
Published online by Cambridge University Press: 09 June 2025
A difficult or failed intubation may occur in the elective or emergency setting, and it is therefore important that every anaesthetist has a plan and knows the failed intubation algorithm. The Difficult Airway Society (DAS) in the UK have published guidelines on the management of failed tracheal intubation which are discussed in this chapter, also described as the ‘Can’t intubate, can’t ventilate’ algorithm. The algorithm follows a stepwise approach starting with Plan A the goal to achieve tracheal intubation and how this may be optimised. Plan B describes the use of supraglottic airway devices to allow for oxygenation when intubation has not succeeded. Plan C advises the clinician to return to facemask ventilation in the case of failed oxygenation and consider waking up the patient if circumstances allow. Plan D describes emergency front-of-neck asses using a scalpel cricothyroidotomy approach.
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