Ultrasonography in Airway Management

All clinicians who provide anesthesia and/or airway management should be able to provide expertise for identifying the cricothyroid membrane, the trachea, and the inflated lung with ultrasonography. This will help when preparing for emergency or elective cricothyrotomy, tracheostomy, and early recognition of a pneumothorax. Airway ultrasonography should be carried out in real time, as a point-of-care technique performed by the same clinician who will utilize the findings during the subsequent, or simultaneous, management of the airway. In addition to these indispensable indications, ultrasonography can serve as a valuable adjunct in a variety of situations for tasks related to airway management, including prediction of difficult laryngoscopy; evaluation of pathology that may influence the choice of airway management technique; diagnosis of obstructive sleep apnea; evaluation of stomach contents; prediction of the appropriate diameter of an endotracheal, endobronchial, or tracheostomy tube; airway-related nerve blocks; ultrasound-guided intubation; confirmation of tracheal or esophageal tube placement; confirmation of gastric tube placement; differentiation of different types of lung and pleura pathology; and prediction of successful extubation. This chapter describes the ultrasonographic findings of the airway from the mouth to the lungs and pleura and the clinical application of these findings.