Intraoperative Laryngospasm and Stridor - Guidelines ...

Intraoperative Laryngospasm and Stridor - Guidelines for Crises in Anaesthesia

❶ Call for help and inform theatre team of problem.

❷ Perform jaw thrust and stop any other stimulation.

❸ Remove airway devices and anything else that may be stimulating or obstructing the airway, e.g. suction catheters, blood or vomit (direct visualisation and suction if in doubt).

  • A correctly positioned tracheal tube rules out laryngospasm.

❹ Give CPAP with 100% oxygen and face mask:

  • Avoid over-vigorous attempts at lung inflation, as this may inflate the stomach.

  • Insert an oro-pharyngeal and/or nasal airway if you are not sure that the airway is clear above the larynx.

❺ If problem persists:

  • Continue CPAP.

  • Deepen anaesthesia.

  • Give a neuromuscular blocker (See Box A).

❻ Consider tracheal intubation particularly if likely to recur.

❼ Use nasogastric tube to decompress the stomach.

❽ Consider other causes (Box B).

❾ Consider whether guideline 2-3 Increased airway pressure may help.

❿ Consider the appropriate strategy, location and support needed for waking the patient.

⓫ Continued airway and ventilation support may be necessary if aspiration has occurred or if the patient has developed negative-pressure pulmonary oedema.

By Association of Anaesthetists @

Quick Reference Handbook - Guidelines for crises in anaesthesia 

#Laryngospasm #Stridor #Anesthesiology #Anesthesia #Intraoperative #Checklist #Diagnosis #Management #Workup 
Contributed by

Dr. Gerald Diaz
Board Certified Internal Medicine Hospitalist, GrepMed Editor in Chief 🇵🇭 🇺🇸 - Sign up for an account to like, bookmark and upload images to contribute to our community platform. Follow us on IG: | Twitter:

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