KP Society of Anaesthesia-KPSA

04/08/2026

In the darkest moments following the Swat bomb blast, when every second meant the difference between life and death, our healthcare teams stood firm with courage and compassion. The Khyber Pakhtunkhwa Society of Anaesthesia (KPSA) proudly appreciates the extraordinary dedication of all anaesthesiologists, doctors, nurses, technicians, and emergency staff who worked tirelessly to save lives. A special tribute goes to Dr. Khalid Khan and Dr. Irfan Ali, whose calm leadership, selfless commitment, and relentless efforts, alongside their teams, brought hope to countless families. Their service reminds us that true heroes are those who choose to stand beside humanity when it needs them the most.

31/07/2026

قابلِ اینستھیٹسٹ (ماہرِ بے ہوشی) کے بغیر سرجری کرنا یا غیر تربیت یافتہ افراد سے اینستھیزیا دلوانا طبی اخلاقیات کی سنگین خلاف ورزی اور شدید طبی غفلت (Gross Medical Negligence) ہے۔ اس سے مریض کی جان کو شدید خطرہ لاحق ہو جاتا ہے اور اس کے نتیجے میں متعلقہ ڈاکٹر یا ادارے کے خلاف فوجداری کارروائی اور پاکستان میڈیکل اینڈ ڈینٹل کونسل (PM&DC) سمیت دیگر ریگولیٹری اداروں کی جانب سے قانونی کارروائی کی جا سکتی ہے۔

آپ کیا کر سکتے ہیں؟ اپنی آواز بلند کریں

آپ بے بس نہیں ہیں۔ عوام درج ذیل اقدامات کے ذریعے ذمہ داروں کا احتساب یقینی بنا سکتے ہیں:

1. اپنی اینستھیزیا ٹیم کی تصدیق کریں:
کسی بھی سرجری سے پہلے مریض کا یہ بنیادی حق ہے کہ وہ پوچھے:
“اس آپریشن کے دوران میری بے ہوشی کی مسلسل نگرانی کرنے والا مستند اینستھیزیا ماہر کون ہے؟”

2. متعلقہ میڈیکل ریگولیٹری ادارے کو شکایت کریں:
اگر کوئی مخصوص کلینک یا سرجن کسی بڑے آپریشن یا گہری بے ہوشی والے طریقۂ علاج کے دوران مستند اینستھیٹسٹ کے بغیر کام کر رہا ہے تو اس کی شکایت متعلقہ میڈیکل لائسنسنگ اتھارٹی یا وزارتِ صحت سے کریں۔ یہ ادارے مریضوں کی شکایات، حتیٰ کہ گمنام شکایات، کی بھی تحقیقات کرتے ہیں۔

3. ہیلتھ کیئر کمیشن میں شکایت درج کرائیں:
پاکستان میں شکایات متعلقہ صوبائی اداروں مثلاً:

* پنجاب ہیلتھ کیئر کمیشن (PHC)
* خیبر پختونخوا ہیلتھ کیئر کمیشن (HCC)
* سندھ ہیلتھ کیئر کمیشن

کے پاس درج کرائی جا سکتی ہیں۔ یہ ادارے کلینکس اور صحت کے مراکز میں حفاظتی معیارات پر عمل درآمد کو یقینی بناتے ہیں۔

4. پیشہ ورانہ تنظیموں کو آگاہ کریں:
اس طرح کے غیر محفوظ طبی طریقوں کی اطلاع پاکستان سوسائٹی آف اینستھیزیالوجسٹس (PSA) اور پاکستان میڈیکل اینڈ ڈینٹل کونسل (PM&DC) کو بھی دیں تاکہ وہ ایسے معاملات کی نگرانی اور مناسب کارروائی کر سکیں۔

مریض کی حفاظت سب سے پہلی ترجیح ہے۔ ہر مریض کو محفوظ، معیاری اور مستند اینستھیزیا خدمات حاصل کرنے کا حق حاصل ہے
Long live KPSA❤️

27/07/2026

Zoom Meeting KPSA
Meeting Minutes

06/07/2026

PRESS RELEASE

Khyber Pakhtunkhwa Society of Anaesthesiologists Holds Annual General Meeting at Hayatabad Medical Complex
Peshawar, July 5, 2026 — The Khyber Pakhtunkhwa Society of Anaesthesiologists (KPSA) convened its Annual General Meeting today at Hayatabad Medical Complex (HMC), Peshawar, bringing together senior members of the anaesthesia fraternity from across the province to deliberate on organizational governance, membership regulation, and professional accountability.
The proceedings were held under the overall leadership of Chairman Dr. Fazal Wadud and President Dr. Javeed Iqbal, and were chaired by General Secretary Dr. Allauddin. The session opened with a recitation from the Holy Quran, followed by a structured, agenda-wise discussion on matters of significant importance to the Society and the wider practice of anaesthesiology in Khyber Pakhtunkhwa.

Elections and Caretaker Cabinet:
By unanimous consensus, members present resolved that KPSA elections will be held in October of this year. To ensure a smooth and impartial transition in the interim period, a caretaker cabinet was formally constituted, with the following members assuming key responsibilities:

Caretaker President: Dr. Salman Malik
Caretaker Chairman: Dr. Shabeer
Caretaker General Secretary: Dr. Jawad Mabood
The remainder of the caretaker cabinet will be finalized by Caretaker President Dr. Salman Malik in consultation and consensus with fellow cabinet members.

Province-Wide Registration Drive:
A central resolution of the meeting was the decision to complete a comprehensive registration process for anaesthesiologists across Khyber Pakhtunkhwa ahead of the October elections. Responsibility for this exercise has been delegated to district-level presidents and their respective teams, who will lead new membership drives within their districts.

At the hospital level, the following members have been tasked with overseeing registration:
Peshawar Institute of Cardiology (PIC): Dr. Allauddin and Dr. Asmat
MTI – Hayatabad Medical Complex (HMC): Dr. Javeed and Dr. Shareef
MTI – Khyber Teaching Hospital (KTH): Dr. Fazal Wadud, Dr. Farzoq, and Dr. Zafar
MTI – Lady Reading Hospital (LRH): Dr. Hasnain, Dr. Shabeer, Dr. Kausar, and Dr. Salman
Institute of Kidney Diseases (IKD): Dr. Khalid
All remaining cabinet members will similarly conduct registration drives at their respective hospitals and share consolidated data with the General Secretary and Information Secretary.
Newly Assigned Portfolios
The meeting also formalized key organizational portfolios to strengthen KPSA's academic, legal, and communications functions:
Head of Academics Wing: Dr. Hasnain, who will lead all academic activities of KPSA
Legal Wing: Dr. Amir
Information Secretary: Dr. Khalid (Swat)
Media Incharge: Dr. Jawad
Spokesperson, KPSA: Dr. Khalid
Finance Wing
The Society also formalized its financial oversight structure for the upcoming term. Dr. Javeed of Swat has been appointed as Finance Secretary, and will oversee monthly funding collection across the various MTI institutions through the following designated teams:

PIC: Dr. Allauddin and Dr. Asmat
KTH: Dr. Zafar and Dr. Farzooq
LRH: Dr. Shabeer, Dr. Kausar, and Dr. Hasnain
HMC: Dr. Javeed and Dr. Shareef
At the district level, funding collection will be carried out by the respective district finance secretaries, with the Dabgari Gardens area to be managed by Dr. Asmat and team.
Ground Data Collection and Regulatory Oversight
In a significant move toward evidence-based advocacy and regulatory compliance, the Society tasked its members with compiling authentic, real-time ground data across the province. This includes:

The total number of hospitals across Khyber Pakhtunkhwa and whether each is staffed with qualified anaesthesiologists.
The number of different healthcare centers currently registered under the name of a single anaesthetist, a practice of particular concern to the Society.
Data collection for private healthcare centers in Peshawar has been assigned area-wise as follows:
Dabgari Gardens: Dr. Asmat, Dr. Shabeer, and Dr. Abdur Rehman Saib
Tehkal: Dr. Kausar
Town and KTH Area: Dr. Zafar and Dr. Shabeer
Ring Road: Dr. Javeed
Hayatabad and Adjacent Areas: Dr. Allauddin and Dr. Shareef
Corresponding data for outlying districts will be compiled and presented by their respective district-level cabinets. The Society has resolved that this entire process of registration and ground-truth data collection must be completed before the October elections, enabling the caretaker cabinet to take appropriate action on any irregularities identified.

Commitment to Constitutional Compliance:

The General Secretary reiterated the Society's firm stance on constitutional discipline, stating clearly that any KPSA member found violating the Society's constitution — whether through malpractice, irregular registration of multiple centers, or other professional misconduct — will be reported to the Health Care Commission and all other competent regulatory authorities. The Society emphasized that it will take firm action against any member violating the constitution, in whatever manner such a violation may occur, reaffirming its commitment to upholding professional standards and patient safety across Khyber Pakhtunkhwa.

Looking Ahead
The Annual General Meeting concluded with a renewed sense of purpose among members to strengthen the Society's institutional framework ahead of the October elections. Through province-wide registration, transparent financial management, robust data collection, and strict adherence to constitutional principles, KPSA aims to reinforce professional accountability and ensure that the practice of anaesthesiology in Khyber Pakhtunkhwa continues to meet the highest standards of patient care and safety.

About KPSA
The Khyber Pakhtunkhwa Society of Anaesthesiologists (KPSA) is the representative professional body for anaesthesiologists practicing across Khyber Pakhtunkhwa province, working to advance the standards of anaesthesia practice, education, and patient safety in the region.

For further information, please contact:
Dr. Allauddin, Founder, KPSA
Dr. Khalid, Spokesperson, KPSA
Dr. Khalid, Swat, Information Secretary, KPSA

Long live KPSA👍❤️

05/07/2026

PRESS RELEASE

Khyber Pakhtunkhwa Society of Anaesthesiologists Holds Annual General Meeting at Hayatabad Medical Complex
Peshawar, July 5, 2026 — The Khyber Pakhtunkhwa Society of Anaesthesiologists (KPSA) convened its Annual General Meeting today at Hayatabad Medical Complex (HMC), Peshawar, bringing together senior members of the anaesthesia fraternity from across the province to deliberate on organizational governance, membership regulation, and professional accountability.
The proceedings were held under the overall leadership of Chairman Dr. Fazal Wadud and President Dr. Javeed Iqbal, and were chaired by General Secretary Dr. Allauddin. The session opened with a recitation from the Holy Quran, followed by a structured, agenda-wise discussion on matters of significant importance to the Society and the wider practice of anaesthesiology in Khyber Pakhtunkhwa.

Elections and Caretaker Cabinet:
By unanimous consensus, members present resolved that KPSA elections will be held in October of this year. To ensure a smooth and impartial transition in the interim period, a caretaker cabinet was formally constituted, with the following members assuming key responsibilities:

Caretaker President: Dr. Salman Malik
Caretaker Chairman: Dr. Shabeer
Caretaker General Secretary: Dr. Jawad Mabood
The remainder of the caretaker cabinet will be finalized by Caretaker President Dr. Salman Malik in consultation and consensus with fellow cabinet members.

Province-Wide Registration Drive:
A central resolution of the meeting was the decision to complete a comprehensive registration process for anaesthesiologists across Khyber Pakhtunkhwa ahead of the October elections. Responsibility for this exercise has been delegated to district-level presidents and their respective teams, who will lead new membership drives within their districts.

At the hospital level, the following members have been tasked with overseeing registration:
Peshawar Institute of Cardiology (PIC): Dr. Allauddin and Dr. Asmat
MTI – Hayatabad Medical Complex (HMC): Dr. Javeed and Dr. Shareef
MTI – Khyber Teaching Hospital (KTH): Dr. Fazal Wadud, Dr. Farzoq, and Dr. Zafar
MTI – Lady Reading Hospital (LRH): Dr. Hasnain, Dr. Shabeer, Dr. Kausar, and Dr. Salman
Institute of Kidney Diseases (IKD): Dr. Khalid
All remaining cabinet members will similarly conduct registration drives at their respective hospitals and share consolidated data with the General Secretary and Information Secretary.
Newly Assigned Portfolios
The meeting also formalized key organizational portfolios to strengthen KPSA's academic, legal, and communications functions:
Head of Academics Wing: Dr. Hasnain, who will lead all academic activities of KPSA
Legal Wing: Dr. Amir
Information Secretary: Dr. Khalid (Swat)
Media Incharge: Dr. Jawad
Spokesperson, KPSA: Dr. Khalid
Finance Wing
The Society also formalized its financial oversight structure for the upcoming term. Dr. Javeed of Swat has been appointed as Finance Secretary, and will oversee monthly funding collection across the various MTI institutions through the following designated teams:

PIC: Dr. Allauddin and Dr. Asmat
KTH: Dr. Zafar and Dr. Farzooq
LRH: Dr. Shabeer, Dr. Kausar, and Dr. Hasnain
HMC: Dr. Javeed and Dr. Shareef
At the district level, funding collection will be carried out by the respective district finance secretaries, with the Dabgari Gardens area to be managed by Dr. Asmat and team.
Ground Data Collection and Regulatory Oversight
In a significant move toward evidence-based advocacy and regulatory compliance, the Society tasked its members with compiling authentic, real-time ground data across the province. This includes:

The total number of hospitals across Khyber Pakhtunkhwa and whether each is staffed with qualified anaesthesiologists.
The number of different healthcare centers currently registered under the name of a single anaesthetist, a practice of particular concern to the Society.
Data collection for private healthcare centers in Peshawar has been assigned area-wise as follows:
Dabgari Gardens: Dr. Asmat, Dr. Shabeer, and Dr. Abdur Rehman Saib
Tehkal: Dr. Kausar
Town and KTH Area: Dr. Zafar and Dr. Shabeer
Ring Road: Dr. Javeed
Hayatabad and Adjacent Areas: Dr. Allauddin and Dr. Shareef
Corresponding data for outlying districts will be compiled and presented by their respective district-level cabinets. The Society has resolved that this entire process of registration and ground-truth data collection must be completed before the October elections, enabling the caretaker cabinet to take appropriate action on any irregularities identified.

Commitment to Constitutional Compliance:

The General Secretary reiterated the Society's firm stance on constitutional discipline, stating clearly that any KPSA member found violating the Society's constitution — whether through malpractice, irregular registration of multiple centers, or other professional misconduct — will be reported to the Health Care Commission and all other competent regulatory authorities. The Society emphasized that it will take firm action against any member violating the constitution, in whatever manner such a violation may occur, reaffirming its commitment to upholding professional standards and patient safety across Khyber Pakhtunkhwa.

Looking Ahead
The Annual General Meeting concluded with a renewed sense of purpose among members to strengthen the Society's institutional framework ahead of the October elections. Through province-wide registration, transparent financial management, robust data collection, and strict adherence to constitutional principles, KPSA aims to reinforce professional accountability and ensure that the practice of anaesthesiology in Khyber Pakhtunkhwa continues to meet the highest standards of patient care and safety.

About KPSA
The Khyber Pakhtunkhwa Society of Anaesthesiologists (KPSA) is the representative professional body for anaesthesiologists practicing across Khyber Pakhtunkhwa province, working to advance the standards of anaesthesia practice, education, and patient safety in the region.

For further information, please contact:
Dr. Allauddin, Founder, KPSA
Dr. Khalid, Spokesperson, KPSA
Dr. Khalid, Swat, Information Secretary, KPSA

Long live KPSA👍❤️

22/06/2026

Long live KPSA👏

19/06/2026

PRESS BRIEFING

Khyber Pakhtunkhwa Society of Anaesthesiologists (KPSA)
Protecting Patients. Upholding Standards. Advancing the Specialty.

Date: June 19, 2026
Issued by: Central Cabinet, KPSA

The Central Cabinet of the Khyber Pakhtunkhwa Society of Anaesthesiologists (KPSA) hereby issues the following official press briefing to the public, healthcare institutions, and all relevant stakeholders across the province.

1. Mandatory Pre-Operative Assessment in All Surgical Facilities
KPSA firmly asserts that a thorough pre-operative anaesthesia assessment is not a luxury — it is a patient right and a medical necessity.
Every patient scheduled for surgery or any procedure requiring anaesthesia must undergo a comprehensive pre-operative evaluation conducted by a qualified anaesthesiologist. This assessment includes evaluation of the patient's medical history, current medications, airway assessment, cardiopulmonary fitness, and identification of any anaesthetic risks prior to the procedure.
KPSA strongly condemns the practice of proceeding with surgical or anaesthetic procedures without proper pre-operative workup, as this directly endangers patient lives. All hospitals, surgical centers, and private facilities across Khyber Pakhtunkhwa are hereby urged to make pre-operative anaesthesia assessment a mandatory and non-negotiable step in every surgical pathway.

2. Physical Availability of Qualified Anaesthesia Doctors
KPSA reaffirms its position that a qualified, registered anaesthesiologist must be physically present during every surgical procedure and anaesthesia administration — without exception.
It has come to the attention of the Central Cabinet that in several hospitals and private surgical centers across the province, anaesthesia is being administered or supervised by unqualified technicians in the absence of a licensed anaesthesia doctor. This is a grave violation of patient safety standards and is entirely unacceptable.
Anaesthesia is a high-risk medical specialty. Any complication — whether airway-related, cardiovascular, or pharmacological — demands the immediate presence and intervention of a trained anaesthesiologist. The absence of such a professional during surgery is not only unethical but potentially fatal.
KPSA calls upon all surgical facilities to ensure the confirmed, documented, and continuous presence of a qualified anaesthesiologist throughout every operative procedure.

3. Availability of Essential Equipment and Standard ASA Monitoring
KPSA demands that all hospitals and surgical centers operating within Khyber Pakhtunkhwa must be equipped with the minimum standard anaesthesia equipment and monitoring as defined by the American Society of Anesthesiologists (ASA) and international patient safety guidelines.
The following represent the non-negotiable minimum standards that must be in place at every facility performing anaesthesia:
✅ Functional anaesthesia machine with a calibrated vaporizer
✅ Continuous pulse oximetry (SpO₂)
✅ Capnography (end-tidal CO₂ monitoring)
✅ Non-invasive blood pressure monitoring (NIBP)
✅ Continuous ECG monitoring
✅ Temperature monitoring
✅ Adequate airway management equipment including emergency airway devices
✅ Suction apparatus
✅ Resuscitation drugs and a functional defibrillator
Performing anaesthesia without this basic monitoring setup is a direct threat to patient safety and constitutes gross negligence. KPSA will not remain silent on facilities that bypass these fundamental requirements in the interest of cost-cutting.

4. KPSA's Formal Engagement with All Stakeholders
The Central Cabinet of KPSA hereby formally announces that it will be actively engaging with all relevant stakeholders to ensure implementation and enforcement of these patient safety standards across the province. These stakeholders include:
🏛️ Khyber Pakhtunkhwa Healthcare Commission (KPHC) — to initiate formal inspection and licensing compliance of all surgical facilities
🏥 Hospital Administrations — to hold them accountable for ensuring qualified staffing and equipment standards
🏛️ Local Administration and Government Authorities — to seek regulatory and legislative support for enforcement
👨‍⚕️ Pakistan Medical and Dental Council (PMDC) — to address issues of unauthorized medical practice
📢 Media and Civil Society — to raise public awareness regarding patient rights in anaesthesia care
KPSA will pursue these concerns through all available legal, professional, and administrative channels until meaningful reform is achieved.
A Message to the Public
Every patient deserves to go into an operating room knowing that a qualified doctor is present, proper monitoring is in place, and their safety is the first priority. KPSA is committed to making this a reality across every district of Khyber Pakhtunkhwa.
We urge the public to ask questions before any surgical procedure:
"Is an anaesthesia doctor going to be present during my surgery?"
"Has my pre-operative assessment been done by a qualified anaesthesiologist?"
Your life matters. Your safety matters. And KPSA stands with you.
For media queries and further information, please contact:
📣 Official Spokesperson — Dr. Khalid Khan (Anaesthesia), KPSA
📍 Khyber Pakhtunkhwa Society of Anaesthesiologists — Central Cabinet
Issued with authority by the Central Cabinet of KPSA
General Secretary, KPSA

Long live KPSA👏❤️

14/06/2026

Videolaryngoscopy — DAS 2025

The Central Change.

The most significant shift in DAS 2025 is the move to first-line videolaryngoscopy (Bjanaesthesia) — meaning it is now the recommended default tool for tracheal intubation in adults, not something you reach for after direct laryngoscopy has already failed.
That equipoise no longer exists. The literature is clear that across patient and provider populations, videolaryngoscopy outperforms direct laryngoscopy and reduces the risk of oesophageal intubation. (ScienceDirect).

What This Means in Practice.

Videolaryngoscopy should be used as the primary attempt at intubation whenever it is available. It is no longer positioned as a rescue technique or a tool reserved for anticipated difficult airways — it is simply the better instrument for most intubations.
DAS 2025 integrates videolaryngoscopy early in Plan A, reflecting evidence that it improves glottic visualisation and reduces failed intubation and complication rates compared with direct laryngoscopy. (NYSORA)

Blade Choice.

DAS 2025 does not mandate a specific blade design. There is currently no strong evidence to recommend one blade design over another. Specific blade types — such as hyperangulated or Macintosh-type — require different techniques. (Bjanaesthesia) The choice depends on the clinical situation, patient anatomy, and operator familiarity. Hyperangulated blades provide a better view in difficult anatomy but require indirect tube delivery skills; Macintosh-style video blades allow a more familiar technique.

An Important Nuance.

In videolaryngoscopy, the link between excellent visualisation and ease of tube delivery may be less direct than with direct laryngoscopy, limiting the interpretative value of view-based descriptors alone. (Bjanaesthesia) In other words, a good view on the screen does not automatically mean an easy intubation — delivering the tube through a hyperangulated blade still requires specific technique and practice.

Availability.

DAS acknowledges that videolaryngoscopy is yet to be universally available, which is why the guidelines specifically state "wherever possible." These guidelines were designed to stand the test of time over the next 8–10 years, and the transition to default videolaryngoscopy is expected to become global. (Bjanaesthesia)
The Broader Picture
This shift aligns with an international trend. A separate international consensus statement in 2025, led by multiple anaesthesiology and emergency medicine societies, strongly endorses videolaryngoscopy as the default first-line approach for airway management in both emergency and elective settings, highlighting its potential to improve safety, standardisation, and training. (Anesthesia Experts)

In short, DAS 2025 closes the debate on
videolaryngoscopy versus direct laryngoscopy. It is the default. Direct laryngoscopy is not abolished — it remains a skill worth maintaining — but videolaryngoscopy is now where you start.

14/06/2026

Airway Ultrasound (AUS) in 2025 – Practical Summary

Airway ultrasound is becoming an important bedside tool for anaesthesiologists, intensivists, and emergency physicians. It is non-invasive, rapid, repeatable, radiation-free, and can be performed in real time at the point of care.
Why Use Airway Ultrasound?

Airway ultrasound can help with:
✅ Airway assessment before intubation
✅ Identification of airway anatomy
✅ Prediction of difficult airway features
✅ Confirmation of tracheal intubation
✅ Detection of oesophageal intubation
✅ Selection of appropriate endotracheal tube size
✅ Confirmation of laryngeal mask airway positioning
✅ Guidance for emergency front-of-neck access
✅ Assessment of vocal cord movement
✅ Identification of airway pathology.

Equipment
High-frequency linear probe (6–15 MHz)
Preferred for:
Tongue
Hyoid bone
Epiglottis
Vocal cords
Cricothyroid membrane
Trachea
Curvilinear probe
Useful for:
Obese patients
Deep neck structures
Important Airway Structures on Ultrasound
Tongue
Appears as a heterogeneous muscular structure.
Increased tongue thickness has been associated with difficult laryngoscopy.
Hyoid Bone
Seen as:
Bright hyperechoic line
Dense acoustic shadow behind it
Acts as a useful landmark.
Epiglottis
Appears as:
Curved hypoechoic structure
Located between hyoid bone and thyroid cartilage
Often described as a "dark curved flap."
Thyroid Cartilage
Hypoechoic structure with bright margins.
More easily visualized in younger patients.
Vocal Cords
Visualized at the level of the thyroid cartilage.
During phonation:
Abduct and adduct symmetrically.
Useful for assessing recurrent laryngeal nerve function.
Cricothyroid Membrane
Located between:
Thyroid cartilage
Cricoid cartilage
Airway ultrasound can accurately identify the membrane even when palpation is difficult.
Particularly useful in:
Obesity
Neck trauma
Distorted anatomy
Trachea
Appears as:
Bright anterior wall
Reverberation artifacts
Air-mucosal interface
Seen in transverse and longitudinal views.
Confirmation of Endotracheal Intubation
One of the most valuable uses of airway ultrasound.
Tracheal Intubation
Findings:
✔ Single air-mucosal interface
✔ Tracheal shadowing
✔ Bilateral lung sliding present
Oesophageal Intubation
Findings:
✔ "Double Tract Sign"
Two air-mucosal interfaces are visualized:
Trachea
Oesophagus
Immediate recognition allows rapid correction.
Lung Ultrasound Confirmation
After intubation:
Bilateral Lung Sliding
Indicates ventilation of both lungs.
Diaphragmatic Movement
Caudal movement during inspiration suggests effective ventilation.
Prediction of Difficult Airway
Several measurements have shown correlation with difficult laryngoscopy:
Tongue Thickness
Increased thickness may indicate difficulty.
Skin-to-Epiglottis Distance
Greater distance associated with difficult laryngoscopy.
Pretracheal Soft Tissue Thickness
Increased anterior neck soft tissue may predict difficult intubation.
Hyomental Distance
Shorter distance may indicate difficult airway.
Airway ultrasound should complement—not replace—clinical airway assessment.
Emergency Front-of-Neck Access
Airway ultrasound helps identify:
Thyroid cartilage
Cricoid cartilage
Cricothyroid membrane
Advantages:
✔ More accurate than palpation
✔ Faster landmark identification
✔ Particularly useful in obese patients
✔ Recommended for anticipated difficult front-of-neck access
Vocal Cord Assessment
Useful before and after:
Thyroid surgery
Cardiac surgery
Neck surgery
Prolonged intubation
Can identify:
Vocal cord paresis
Vocal cord paralysis
Asymmetric movement
Tube Size Selection
Ultrasound measurement of:
Subglottic Diameter
Can guide:
Paediatric ETT selection
Double-lumen tube sizing
Tracheostomy tube selection
Often more accurate than age-based formulas in children.

Current Limitations.

❌ Operator dependent
❌ Requires training and experience
❌ Air limits ultrasound pe*******on
❌ Calcified cartilage may obscure images
❌ Standardized difficult airway cut-offs remain under investigation.

Key Take-Home Messages:

🔹 Airway ultrasound is a valuable point-of-care adjunct for airway management.
🔹 It improves identification of airway anatomy and confirmation of tracheal intubation.
🔹 The "Double Tract Sign" is highly suggestive of oesophageal intubation.
🔹 Ultrasound accurately identifies the cricothyroid membrane, especially in obese or difficult neck anatomy.
🔹 It can assist in predicting difficult laryngoscopy and selecting appropriate airway devices.
🔹 Airway ultrasound complements clinical assessment, capnography, and established airway management strategies rather than replacing them.
Simple Airway Ultrasound Flow
Pre-intubation ↓ Identify anatomy ↓ Assess difficult airway markers ↓ Locate cricothyroid membrane
During intubation ↓ Real-time tracheal ultrasound ↓ Exclude oesophageal intubation (Double Tract Sign)
Post-intubation ↓ Confirm lung sliding ↓ Assess diaphragmatic movement ↓ Verify effective ventilation
Airway ultrasound is increasingly regarded as the "visual stethoscope" of modern airway management, providing rapid anatomical and functional information before, during, and after airway intervention.

14/06/2026