Intraoperative Laryngospasm and Stridor - Guidelines for Crises in Anaesthesia ❶ Call for help and inform theatre team of problem. ❷ Perform jaw thrust and stop any other stimulation. ❸ Remove airway devices and anything else that may be stimulating or obstructing the airway, e.g. suction catheters, blood or vomit (direct visualisation and suction if in doubt). • A correctly positioned tracheal tube rules out laryngospasm. ❹ Give CPAP with 100% oxygen and face mask: • Avoid over-vigorous attempts at lung inflation, as this may inflate the stomach. • Insert an oro-pharyngeal and/or nasal airway if you are not sure that the airway is clear above the larynx. ❺ If problem persists: • Continue CPAP. • Deepen anaesthesia. • Give a neuromuscular blocker (See Box A). ❻ Consider tracheal intubation particularly if likely to recur. ❼ Use nasogastric tube to decompress the stomach. ❽ Consider other causes (Box B). ❾ Consider whether guideline 2-3 Increased airway pressure may help. ❿ Consider the appropriate strategy, location and support needed for waking the patient. ⓫ Continued airway and ventilation support may be necessary if aspiration has occurred or if the patient has developed negative-pressure pulmonary oedema. By Association of Anaesthetists @ https://twitter.com/AAGBI Quick Reference Handbook - Guidelines for crises in anaesthesia #Laryngospasm #Stridor #Anesthesiology #Anesthesia #Intraoperative #Checklist #Diagnosis #Management #Workup
