How Will the Difficult Airway Management (DAM) Algorithm Change in 2013?

• Published in: Nihon Rinshō Masui Gakkai shi Vol. 32; no. 2; pp. 182 - 190
• Main Authors: NAKAGAWA, Masashi, KAMINOH, Yoshiroh
• Format: Journal Article
• Language: English; Japanese
• Published: THE JAPAN SOCIETY FOR CLINICAL ANESTHESIA 2012
• Subjects: DAM guideline; Difficult mask ventilation; Oxygenation; Supraglottic device
• ISSN: 0285-4945; 1349-9149; 1349-9149
• DOI: 10.2199/jjsca.32.182

The American Society of Anesthesiologists published the Practice guidelines for management of the difficult airway in 1993, and revised it in 2003. I expect that the following revised edition will be announced around 2013. I would like to forecast the next algorithm which reflects the progress of the airway management technology for the past ten years. At the 2003 revision, the laryngeal mask airway (LMA) came to be used in difficult airway situations, such as difficult mask ventilation and difficult intubation. After that, the LMA and other supraglottic devices became more popular and have grown into an important category of airway management. Thus, these supraglottic devices might play an important role in airway management. Mask ventilation is the most primitive and valuable maneuver for oxygenation, however, the strategy for difficult mask ventilation had not completely been described in the 2003 guideline. Recently, a lot of articles about difficult mask ventilation were published, thus, the strategy for difficult mask ventilation will be included. The bottom line is that the new algorithm will stress continuing oxygenation by mask or supraglottic devices ventilation instead of tracheal intubation.