Le contrôle des voies aériennes: Du meilleur au pire

In summary, it is clear that no single airway assessment can reliably predict a difficult airway. This is due largely to the low incidence of difficult airway, making the positive predictive value of an airway assessment unreasonably low. Nevertheless, preoperative airway assessment in essential as illustrated by Dr. Shandling's letter in this issue of the journal. It is also critical to equip ourselves with various alternative airway techniques for the unanticipated difficult airway. While there are significant advances in the development of effective airway techniques during the last two decades, most Canadian anesthesiologists do not use these effective alternatives when encountering airway difficulties. Perhaps we should review our training programs and develop strategies in teaching airway management as suggested by the CAFG. Together with well organized airway workshops and regular practice with these alternative techniques in patients with normal airways, it is hoped that all anesthesiologists will acquire and update the necessary airway skills to manage patients presenting with a challenging airway.