Management of difficult airways in surgical patients at the Port Moresby General Hospital operating theatre and intensive care unit.

Abstract

We report on the results of a retrospective audit of airway management in patients presenting to the Port Moresby General Hospital from 1998 to 2009. Safe and secure airway management can be challenging in the operating room during head and neck surgery. These challenges continue into the postoperative period and can present significant issues to intensive care staff. This series includes many patients with upper airway and upper gastrointestinal malignancy, head and neck trauma, head and neck infections, thyroid pathology and cleft palate. This series highlights the importance of anticipating the possibility of difficult airway preoperatively and modifying the airway management appropriately. We consider that all members of the operating team including surgeons, anaesthetists, intensive care physicians and nursing staff should cooperate and communicate effectively to optimize outcomes for these potentially difficult cases. A proposed airway management algorithm is presented to guide surgical teams performing head and neck surgery in Papua New Guinea and similar regions.