Endotracheal intubation is the gold standard for maintaining airway patency and protection in critically ill patients. Conventional direct laryngoscopy is commonly performed but has many potential complications especially in patients with difficult or failed airways. These complications can significantly increase morbidity and mortality and should be avoided. Recognizing a difficult airway is a vital component in the intubation process. Proper preparation of equipments and strategies should be planned in such cases. One such strategy is the usage of flexible endoscopy for endotracheal intubation in both anticipated and unanticipated difficult airways.
We described a total of eight cases that were intubated using flexible endoscopic awake intubation in Emergency Department (ED) of Hospital Serdang. All eight cases were predicted to have difficult airways to intubate, and consist of both medical and trauma patients. All of the endotracheal intubations were performed successfully in this cohort of patients with no complications.
Flexible endoscopic intubation of the “awake” patient is a safe and effective method to be used in the Emergency Department. It is the method of choice for intubating the anticipated difficult airway group of patients. Awake intubation can considerably reduce the risk of hypoxia. It allows the procedure in the conscious, spontaneously breathing patient to remain oxygenated using topical anaesthesia and mild sedation only until the endotracheal tube is place.