Figure 2.

Proposed algorithm for the management of the neonatal unanticipated difficult airway. The red column describes the situation where mask ventilation is difficult and/or impossible to achieve despite measures including the insertion of an oropharyngeal or nasopharyngeal tube, and two-person mask ventilation. The red column is the most time critical. The blue column is the situation where mask ventilation is possible, but the newborn is difficult to intubate, e.g., a semi-vigorous baby where positive pressure ventilation is considered ineffective or prolonged. In this situation there is usually time to reevaluate the initial management plan and reposition the head of the newborn for another intubation attempt with a videolaryngoscope. DR, Delivery Room; FONA, Front of neck access; NICU, Neonatal intensive care unit; SAD, Supraglottic airway device.