A guide to airway management

A patent airway linking the nose and mouth with the lungs is essential to life. Critically ill people often experience airway difficulties for reasons including alterations in consciousness, the use of sedating medications, and inflammatory changes within the airway. Airway management is therefore a core skill for any clinician caring for critically ill people. This article briefly reviews the anatomy and physiology of the airway before moving on to consider causes of airway obstruction. A look-listen-feel approach to airway assessment is described, followed by a discussion of techniques used to clear, open and maintain the airway. Commonly used airway devices including oropharyngeal, nasopharyngeal and supraglottic airways are evaluated, and their indications and insertion techniques discussed. The role of the endotracheal tube in the critically ill person is also considered.