It’s important to avoid excessive airway trauma, therefore if two attempts at secondary tracheal intubation have been unsuccessful, further efforts should be avoided.

Elective surgery can be postponed. The supraglottic airway device should be left in situ if it is enabling adequate ventilation and oxygenation. It should only be removed once muscle relaxation has worn off, spontaneous ventilation has returned and the patient is awake.

If the supraglottic device is ineffective, it should be removed and ventilation should be attempted via a face mask, using a one or two person technique with or without an oral or nasal airway.