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Anaesthesia. 2009 Jun;64(6):601-8. doi: 10.1111/j.1365-2044.2009.05888.x.

The formulation and introduction of a 'can't intubate, can't ventilate' algorithm into clinical practice.

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Royal Perth Hospital, Perth, Western Australia, Australia.


Both the American Society of Anesthesiologists and the Difficult Airway Society of the United Kingdom have published guidelines for the management of unanticipated difficult intubation. Both algorithms end with the 'can't intubate, can't ventilate' scenario. This eventuality is rare within elective anaesthetic practice with an estimated incidence of 0.01-2 in 10,000 cases, making the maintenance of skills and knowledge difficult. Over the last four years, the Department of Anaesthetics at the Royal Perth Hospital have developed a didactic airway training programme to ensure staff are appropriately trained to manage difficult and emergency airways. This article discusses our training programme, the evaluation of emergency airway techniques and subsequent development of a 'can't intubate, can't ventilate' algorithm.

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