Anaes SAQs · Obstetric anaesthesia
Failed intubation in obstetrics: OAA/DAS algorithm and wake-versus-proceed
Final-examination SAQ for failed-obstetric-intubation.
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Target exams
ANZCAFRCAEDAICABAFCAI
Prompt
Category-1 caesarean under GA: two optimised VL attempts fail. Outline OAA/DAS management, wake-versus-proceed factors, and actions if oxygenation cannot be achieved.
Model answer
Immediate (5). Declare failed intubation, call for help, 100% oxygen, maintain uterine displacement, limit further DL, insert second-generation SGA, consider gentle facemask if needed.[1]
Wake vs proceed (5). Tabulate maternal airway security, fetal urgency (category-1 bradycardia favours proceed), team skill, and regional conversion options.[1]
CICO (5). Front-of-neck access without delay, arrest algorithm, timely perimortem CS at the point of collapse if maternal oxygenation cannot be achieved.[1]
References2ShowHide
- [1]Mushambi MC, Kinsella SM, Popat M, et al. Obstetric Anaesthetists' Association and Difficult Airway Society guidelines for the management of difficult and failed tracheal intubation in obstetrics. Anaesthesia, 2015.PMID 26449292
- [2]Frerk C, Mitchell VS, McNarry AF, et al. Difficult Airway Society 2015 guidelines for management of unanticipated difficult intubation in adults. British Journal of Anaesthesia, 2015.PMID 26556848