Summary

    Problems with tracheal intubation are infrequent but are the most common cause of anaestheticdeath or brain damage. The clinical situation is not always managed well. The Dif?cult AirwaySociety （DAS） has developed guidelines for management of the unanticipated dif?cult trachealintubation in the non-obstetric adult patient without upper airway obstruction. These guidelineshave been developed by consensus and are based on evidence and experience. We have produced?ow-charts for three scenarios: routine induction; rapid sequence induction; and failed intubation,increasing hypoxaemia and dif?cult ventilation in the paralysed, anaesthetised patient. The ?ow-charts are simple, clear and de?nitive. They can be fully implemented only when the necessaryequipment and training are available. The guidelines received overwhelming support from themembership of the DAS.Disclaimer: It is not intended that these guidelines should constitute a minimum standard of practice,nor are they to be regarded as a substitute for good clinical judgement.

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