The secondary air leak test can be performed to detect significant obstructing laryngeal edema.

Monitoring of the patient after extubation shall be performed by qualified personnel.New symptoms that may indicate the development of an airway complication (e.g.,hoarseness, (increasing) swelling, difficulty swallowing, chest pain, and emphysema formation) shall be recognized early.

To successfully secure the unexpected and expected difficult airway, sound education and regular training, including simulation, shall be provided.

Regular training should be provided on airway trainers for translaryngeal/transtracheal techniques.

When direct laryngoscopy is expected to be difficult or in emergencies, video laryngoscopy should be preferred over direct laryngoscopy.

In anesthesia, a video laryngoscope with a Macintosh blade can be used for standard intubation.

A stylet shall be used when using a hyper angulated blade with sufficient practical ex_x005Fperience to use these devices successfully in emergency situations. The tube with the stylet should be bent to follow the shape of the blade all the way to the tip.

Devices for each level shall be available dur_x005Fing elective and emergency airway management.

Prior to induction of general anesthesia, the team shall communicate the planned proce_x005Fdure and any special features. If difficulties are anticipated, the course of action and possible alternatives shall be specified.

There shall be an institution specific algo_x005Frithm for difficult airway management available. It is known to all involved and includes available and familiar devices and airway techniques.