Emergency Airway Management

Airway skills are perhaps the most important skills that an emergency physician possesses. If the airway is lost in a critically ill patient for any reason, any of the other interventions you might make, or any great diagnoses are superfluous. It is good to remember that in the ABC’s of resuscitation, airway is first and foremost. With the exception of defibrillation in a cardiac arrest situation and possibly a needle decompression in the patient with a tension pneumothorax, airway control always assumes first priority. Since the need to protect the airway most often occurs in a crisis situation in the ED, the emergency physician can not rely on others, like anesthesia, to assist. Even moments of delay can spell disaster for the patient. Since every airway emergency presents in a different fashion, the emergency physician must be proficient in multiple techniques to protect and intubate the airway, and must be prepared with all the necessary equipment to perform these alternative procedures should the initial plan fail.