The difficult airway has been defined as a “clinical situation in which a conventionally trained anesthesiologistexperiences difficulty with mask ventilation of the upper airway, tracheal intubation, or both.” Given the potentially lifethreateningconsequences, the American Society of Anesthesiology has developed an airway algorithm that focuses onestablishing an airway, generally for the induction of anesthesia. However, there is no algorithm on how to safelytransition from an established airway back to the normal, natural airway. Up to 0.19 percent of patients can requirereintubation in the post anesthesia recovery unit, with the known difficult airway at greater risk in these settings for failedreintubation. Because of this, there has been recognition of the need for guidelines in the form of an algorithm to deal withextubation in these patients. To fill this current need, we propose the following difficult to intubate patient extubationalgorithm for use in the operating room setting.
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