Manual Of Airway Management In Critical Care: The Intensivist's Guide To Rsi, Difficult Airway Prediction, Video Laryngoscopy, Airway Rescue, Tracheostomy And Post-Intubation Icu Management

Airway management in the intensive care unit carries a distinct risk profile from every other clinical environment in which intubation occurs. The ICU patient is physiologically compromised before the procedure begins. Desaturation is faster, hemodynamic collapse more likely, and the margin for error narrower than in the operating theatre or the emergency department. MANUAL OF AIRWAY MANAGEMENT IN CRITICAL CARE is written specifically for clinicians who manage airways in critically ill adult patients. Organized across several chapters, it addresses the full procedural and clinical arc of critical care airway work, from the decision to intubate through device selection, technique execution, pharmacological management, post-intubation care, and long-term tracheostomy management. The manual opens with four chapters establishing the foundational context: the epidemiology and outcomes data that explain why ICU airway management is categorically different, the applied anatomy and biomechanics relevant to the intubating intensivist, and the cardiorespiratory physiology changes that occur during airway intervention in the critically ill. These chapters build the physiological framework that underpins every clinical decision covered later in the text. The difficult airway is addressed across three dedicated chapters covering anatomical prediction, hemodynamic instability and shock states, and the compounding challenges of hypoxemia, metabolic acidosis, coagulopathy, and systemic derangements. Each chapter moves from the physiological mechanism to structured clinical assessment and preparation strategies. Procedural preparation receives detailed coverage. Chapters address the decision to intubate and timing considerations, ICU airway strategy development including algorithms and mental models, airway ultrasound for assessment and post-intubation confirmation, preoxygenation and apneic oxygenation with the supporting evidence base, and physiological optimization before laryngoscopy covering hemodynamics, volume status, and monitoring. A dedicated chapter covers team preparation, setup, and checklists for maximizing first-attempt success. The pharmacology section covers induction agents with mechanism and selection guidance for the critically ill, neuromuscular blocking agents including RSI protocols and dosing in organ dysfunction, hemodynamic support with vasoactive agents and push-dose strategies, and topical anesthesia and airway blocks for awake intubation. Device-specific technique chapters cover bag-mask ventilation and rescue oxygenation, direct laryngoscopy technique optimization, video laryngoscopy with device selection and ICU-specific application, supraglottic and extraglottic airway devices, flexible endoscopic and awake tracheal intubation, optical stylets and tube introducers, and surgical airway access including cricothyrotomy and front-of-neck emergency techniques. Crisis management is addressed in two chapters covering failed airway recognition and decision algorithms, and combination rescue techniques and recovery from airway crisis. Post-intubation care covers initial ventilator settings and lung-protective strategies, hemodynamics, sedation-analgesia protocols, the ventilator care bundle, and extubation readiness assessment including high-risk extubation and tube exchange. Tracheostomy in critical care is covered in a dedicated chapter addressing indications, timing, percutaneous and surgical techniques, and decannulation. The final chapters address airway management in special clinical populations and environments, and human factors and institutional airway safety program development. Written for intensivists, critical care fellows, emergency physicians with ICU responsibilities, anesthesiologists, advanced practice providers, and respiratory therapists who manage or support airway procedures in critically ill adult patients.