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O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E | F E B R U A R Y 2 0 1 4
Espada, MSN, CRNA, chief nurse anesthetist
at Gateway Surgery Center in Concord, N.C.
"That's the very first assessment for every
patient. You're always wondering, 'What if I
have a difficult airway?'"
A pre-operative assessment to identify at-risk
patients is always the best frontline defense. "If
you don't do a thorough airway exam before
you put someone to sleep, you're just asking
for trouble," says Mr. Espada. "Don't just roll
them out because they look healthy — espe-
cially if you're practicing by yourself and you
don't have 2 sets of hands."
You'll discover most difficult airways during
induction when you can't intubate or ventilate
by other means, says anesthesiologist Charles
Beck, DO, of McKinney, Texas. "An anticipat-
ed difficult airway will always be better than a
surprise," says Michael Karren, CRNA, MS, of
Madison Anesthesia Services in Rexburg,
Idaho. Will the presence of a fiberscope or
video LMA make you feel secure anesthetiz-
ing a patient with a known difficult airway?
Mr. Karren's advice: Practice with video
scopes and a variety of other advanced tech-
niques on easy and routine cases to build con-
fidence for when you need them for real.
"And call for backup early," he adds.
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