Guidelines for Complications of Cancer Treatment Vol VIII Part B

2. An evaluation for general clinical factors that mayproduce an adverse impact on ventilation after the patienthas been extubated.3. The formulation of an airway management plan that canbe implemented if the patient is not able to maintainadequate ventilation after extubation.4. A consideration of the short-term use of a device thatcan serve as a guide for expedited reintubation. Thistype of device is usually inserted through the lumen ofthe tracheal tube and into the trachea before the trachealtube is removed. The device may be rigid to facilitateintubation and/or hollow to facilitate ventilation.(insufficient data)Follow-up CareThe anesthesiologist should document the presence and natureof the airway difficulty in the medical record. The intent ofthis documentation is to guide and facilitate the delivery offuture care. Aspects of documentation that may prove helpfulinclude (but are not limited to)1. A description of the airway difficulties that wereencountered.The description should distinguish betweendifficulties encountered in face mask or LMA ventilationand difficulties encountered in tracheal intubation.2. A description of the various airway managementtechniques that were employed. The description shouldindicate the extent to which each of the techniques serveda beneficial or detrimental role in management of thedifficult airway. (insufficient data)Monitoring for awareness under anaesthesiaIntraoperative awareness under general anesthesia is a rareoccurrence, with a reported incidence of 0.1–0.2%.1–4Significant psychological sequelae (e.g., post–traumatic stress68