SIM Scenario Exchange

Difficult Intubation

Contributed on January 24, 2025, last reviewed and/or updated on January 24, 2025.

English

Author(s)

  • Rewand Latvanen RRT, MEd

  • Lily Sun, RRT, BSc

  • Greg Donde RRT, MSc, FCSRT

  • Fanshawe College, Respiratory Therapy Program

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A patient with a potentially difficult airway requires intubation for worsening upper airway obstruction. The team performs an airway assessment, develops a plan and prepares equipment. Prior to intubation an intubation pause is performed. The first intubation attempt with a video laryngoscope fails. The second attempt with video laryngoscope, a bougie, and smaller ETT also fails due to poor view and abnormal structures. The patient is challenging to bag mask ventilate, even with trouble shooting. An Supraglottic airway is placed with little improvement and worsening hypoxemia.  One last attempt at intubation with video laryngoscope by another RT fails. A cricothyrotomy is then successfully performed by the DR and the patient achieves effective ventilation and stabilizes.  

Learning Objectives:

By the end of this simulation, you will be able to:

  1. Develop a comprehensive airway management plan that includes strategies for potentially difficult intubation.

  2. Demonstrate proper techniques for initial airway management.

  3. Differentiate and prioritize between various backup airway management strategies based on the patient’s response and airway structure.

  4. Recognize and make informed decisions on escalating care when initial attempts fail.

  5. Identify effective team communication and coordination during the management of a difficult airway scenario.

Simulation Modality:

Virtual gaming simulation / virtual patient

Keywords:

302, Affinity Learning

Citation:

Latvanen R, Sun L, Donde G.. Difficult Intubation. Simulation resource published by Simulation Canada; 2025. Available from https://simulationcanada.ca/scenario/difficult-intubation/.

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License:

The information about this resource and any downloadable files are shared under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

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Target Learners

Interprofessional:

No

Profession:

Respiratory Therapy

Levels:

Undergraduate / post-secondary

Fields / Disciplines:

Anesthesia / peri-anesthesia care
Clinical Procedures
Emergency / trauma
Resuscitation
Team Collaboration

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