Development of the Obstetric Unanticipated Difficult Video-laryngoscopy Algorithm Through a Quality Improvement Randomized Open-label In Situ Simulation Study

( Int J Obstet Anesth . 2024;60:104245 doi: 10.1016/j.ijoa.2024.104245) The study aimed to develop and evaluate an algorithm using simulation for managing unanticipated difficult video-laryngoscopy (VL) during obstetric emergencies. Given the higher risk of difficult tracheal intubation during cesarean deliveries (CDs) performed under general anesthesia, the study sought to determine the most effective approach to securing the airway quickly and safely to reduce the risk of maternal and fetal complications associated with hypoxemia. Previous literature suggests that combination airway techniques improve success rates compared to single-device approaches. The researchers hypothesized that using a flexible bronchoscope (FB) with VL would result in faster airway securement than the Eschmann endotracheal tube introducer (EI) with VL.