Anaes · Airway management
Airway emergencies: recognition and the structured response
Also known as Airway emergencies · The airway crisis · The lost airway · Intraoperative airway emergency · Acute airway obstruction · Crisis resource management in the airway
An airway emergency is any acute failure to oxygenate or ventilate — from laryngospasm and bronchospasm to aspiration, obstruction, the lost airway and cannot-intubate-cannot-oxygenate. Survival hinges less on a single heroic technique than on early recognition, calling for help, basic airway manoeuvres applied well, and a structured, rehearsed escalation — because the time from a falling saturation to a hypoxic cardiac arrest is short.
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8 MCQs with explanations
Target exams
Red flags
Meet the patient
A fit twenty-year-old emerges from a brief general anaesthetic for a hand surgery. He coughs on the tube, the cords snap shut, and within thirty seconds the saturation is in the eighties and the heart rate is slowing. The monitor's bradycardia alarm is the heart surrendering to hypoxia, not a primary rhythm problem.[1][6]
The single decision that saves this patient is the one examiners test over and over: do not chase the bradycardia with an antimuscarinic — chase the hypoxia with oxygenation. Everything in this topic hangs off that discipline: recognise early, call early, oxygenate by whatever means works, and escalate through a rehearsed sequence before the saturation reaches the range from which recovery is unlikely.[1]
You have read the opening of this topic. The complete unit — every section and its primary-source references — is part of the Anaesthesia fellowship atlas.
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- [1]Pařízek T, Waldauf P, Kalina M, et al. Effect of atropine on time to cardiac arrest in hypoxic bradycardia: a randomised cross-over study in a porcine apnoea model BJA Open, 2026.PMID 42317406
- [2]Wu X, et al. Airway Decision-Making in Acute Epiglottitis: A Case Report of Planned Tracheostomy in a Can Ventilate but Cannot Intubate (CVCI) Scenario Clin Case Rep, 2026.PMID 42290811
- [3]Mullally ME, et al. Evaluation of novel materials for front-of-neck access simulations Anaesth Intensive Care, 2026.PMID 42290043
- [4]Sato M, et al. Suspected Neostigmine-Associated Bronchospasm Complicated by Pulmonary Edema During General Anesthesia: A Case Report Cureus, 2026.PMID 42311723
- [5]Del Tedesco JC, et al. [The mindset of anesthesiologists while performing surgical airway management] Anaesthesiologie, 2026.PMID 42230350
- [6]Karim HMR, et al. Letter to the Editor: Insight into emergency endotracheal intubation in critically ill and strategies beyond equipment World J Crit Care Med, 2026.PMID 42272892