Tracheal intubation is a fundamental skill in airway management and there are several techniques used to achieve this. Classically, the use of a laryngoscope has been used for intubation of the airway by allowing direct visualisation of the glottis. A range of laryngoscopes exist with differences in their blades and sizes with the Macintosh blade the most frequently used. Other laryngoscopes discussed include the Miller and McCoy. Videolaryngoscopes consist of a high-resolution camera at the tip of the blade to allow for indirect visualisation of the glottis. Similarly, the range of shapes and sizes is vast. The use of videolaryngoscopes has introduced the ‘shared screen’ principle allowing others to also have a view during intubation and this can aid training and teaching. Awake tracheal intubation can be performed using flexible scopes or videolaryngoscopes and is recommended for anticipated difficult airway cases. Confirmation of tracheal tube placement is critical and should be performed in every case using capnography. Clinical signs may be unreliable and additional uses of flexible scopes and ultrasound may also be used.

A difficult or failed intubation may occur in the elective or emergency setting, and it is therefore important that every anaesthetist has a plan and knows the failed intubation algorithm. The Difficult Airway Society (DAS) in the UK have published guidelines on the management of failed tracheal intubation which are discussed in this chapter, also described as the ‘Can’t intubate, can’t ventilate’ algorithm. The algorithm follows a stepwise approach starting with Plan A the goal to achieve tracheal intubation and how this may be optimised. Plan B describes the use of supraglottic airway devices to allow for oxygenation when intubation has not succeeded. Plan C advises the clinician to return to facemask ventilation in the case of failed oxygenation and consider waking up the patient if circumstances allow. Plan D describes emergency front-of-neck asses using a scalpel cricothyroidotomy approach.

This chapter describes the principles and practice of anaesthesia for dental surgery. A comprehensive account of the assessment, planning and conduct of anaesthesia is given. Commonly performed dental procedures are considered in detail, together with the management of dentofacial infection and maxillofacial trauma in children.

Videolaryngoscopes have been in existence for several decades but in the last decade have taken a central role in both difficult and routine airway management. During that time videolaryngoscopy has not only become embedded in most difficult airway algorithms but the technique has become part of core airway management skills and the use of awake videolaryngoscopy has increased. This chapter describes the various types of videolaryngoscopes, their roles, strengths and limitations. Strategies to optimise use of Macintosh and hyperangulated devices are described as well as which adjuncts are best suited to their use. The issue of ‘can see, cannot intubate’ is discussed along with techniques to overcome it. The role of videolaryngoscopy outside the operating theatre, in critical care, in the emergency department and in pre-hospital care is discussed in this and other chapters.