Global airway management of the unstable cervical spine survey (GAUSS)

Abstract

Unstable cervical fractures pose a twofold challenge: patients may present with a difficult airway and the airway intervention itself could cause or exacerbate spinal cord injury. Reasons for a difficult airway may include limited mouth opening as well as limited movement due to spinal motion restriction techniques employed. Patients can be hypotensive, hypovolaemic, hypoxic, or present with a threatened airway due to spinal cord or associated injuries.5 Maxillofacial injuries and/or intraoral bleeding may further complicate management while the mean blood pressure should be maintained at 90 mmHg, or above.6 The clinician is tasked with multiple problems that require simultaneous management, so that these patients can often be challenging for the anaesthetist.