"New" ASA Difficult Airway Guidelines 2012

The long awaited new ASA airway management guidelines incorporate the Video laryngoscope for the first time. GlideScope is the most widely used device of this kind. GlideScope  led development of this practice change.
1. The Algorithm features Video Laryngoscopy as a potential first choice in the initial assessment phase.
2. Then the Video laryngoscope is the first mentioned option for " alternate approaches to intubation" where rescue is required.
The primary ASA table is presented here .

DIFFICULT AIRWAY ALGORITHM

1.  Assess the likelihood and clinical impact of basic management problems:

•  Difficulty with patient cooperation or consent

•  Difficult mask ventilation

•  Difficult supraglottic airway placement

•  Difficult laryngoscopy

•  Difficult intubation

•  Difficult surgical airway access

2.  Actively pursue opportunities to deliver supplemental oxygen throughout the process of difficult airway management.

3.  Consider the relative merits and feasibility of basic management choices:

•  Awake intubation vs. intubation after induction of general anesthesia

•  Non-invasive technique vs. invasive techniques for the initial approach to intubation

•  Video-assisted laryngoscopy as an initial approach to intubation

•  Preservation vs. ablation of spontaneous ventilation

 

Alternative approaches to intubation  include:
  Video laryngoscopy, alternative laryngoscope blades, SGAs like  the LMA, light wand, flexible laryngoscopes and others.

The document is very detailed and is required reading for aspiring  "Airway Managers".
Anesthesiology  Feb 2013  vol. 118, No. 2.