CPD Article Failed tracheal intubation in primary health care

Indiran Govender, Doudou K. Nzaumvila, Olga M. Maphasha

About the author(s) Indiran Govender, Department Family Medicine and Primary Health Care, Faculty of Health Sciences, Sefako Makgatho Health Sciences University, Pretoria, South Africa
Doudou K. Nzaumvila, Department Family Medicine, Faculty of Health Sciences, Sefako Makgatho Health Sciences University, Pretoria, South Africa
Olga M. Maphasha, Department of Family Medicine, Faculty of Medicine, University of Pretoria, Pretoria, South Africa

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Abstract

Tracheal intubation in primary health care is a necessary skill and usually one that is necessary for appropriate emergency management of unstable patients. Primary care practitioners may not have an anaesthetist or critical care doctor available to help them in these emergencies and must manage these patients themselves. Often tracheal intubation may fail because of multiple possible factors and a different course of action may be needed to minimise the potential for harm to the patient. The primary care professional or family physician will have to manage this failed intubation. Primary health care facilities providing obstetric services must have guidelines and appropriate equipment for management of airway problems. This article will explore reasons for the failure of tracheal intubation and how this can be managed.

Keywords

failed intubation; anaesthesia; airway management; primary health care; Mallampati classification; video laryngoscope; hypoxia; hypotension

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