The difficult airway in critical care

Airway management with orotracheal intubation is one of the basic skills of a critical care practitioner. The oral route is the most common and easily mastered approach for tracheal intubation. Routinely, this technique involves visualization of the glottis, the use of a laryngoscope, and passage of the endotracheal tube into the trachea under direct vision. In many instances, this technique cannot be accomplished and the clinician needs to access the airway utilizing a variety of techniques. The patient with a difficult airway represents a significant problem for health care providers dealing with critical situations. This article describes some of the common approaches that can be used when a difficult airway is present.