Difficult airway management - a constant challenge.

Airway management during anaesthesia and in the critically ill patient admitted to the intensive care unit (ICU) has seen significant advances since the beginnings of anaesthesia practice. Nevertheless, the difficult airway remains up until now one of the greatest challenges of the anaesthetist, with possible dramatic consequences for the patient when failing to intubate and failing to ventilate. Airway management remains one of the prime skills of any anaesthesia provider and directly affects patient safety in the surgical or ICU setting. During the last decades anaesthesia has become increasingly safe, with a practice based on clear guidelines and protocols, but nevertheless failed airway management still leads to feared complications, that although rare, can sometimes be life-threatening. Airway management is strongly influenced by context, with rates of failed intubation that differ in the hospital vs. pre-hospital setting. Another great determinant is the urgency context of the surgical intervention. Therefore, the incidence of failed intubation varies as follows, based on the aforementioned situations: elective surgery setting failed intubation incidence is approximately 1 in every 1000 cases [1], during rapid sequence induction (RSI) it is around 1 in 300 cases [2], with an even higher incidence (1 in 100 cases ) in the ICU, emergency department, and pre-hospital setting [3]. Difficulty in airway management includes multiple entities according to the Practice Guidelines for Management of the Difficult Airway updated by the American Society of Anesthesiology. These entities DOI: http://dx.doi.org/10.21454/rjaic.7518.252.pop