To the Editor:—

As a bearded anesthetist, I was interested to read the solution of Drs. Johnson, Bradway, and Blood to the problem of good mask ventilation in the presence of an hirsute face. 1Although they are correct in their assertion that it is a frequently encountered situation, they are incorrect in their statement that the only previously published solution has been to shave the patient preoperatively. In Great Britain, we are often accused of lagging behind our transatlantic colleagues, especially where high-technology medicine is concerned. However, the technique that Johnson suggests of applying a clear intravenous site dressing is similar to the use of a cut defibrillator pad, which was suggested in a recent correspondence about in the journal Anaesthesia . 2An added advantage of using defibrillator pads is that an urgent shout for them attracts the attention of nearby staff, who might otherwise be preoccupied. Other ideas presented in the correspondence include (1) the use of plastic kitchen wrap around the entire head, which is not to be used with an unstable cervical spine, 3and (2) placing the caudal end of the mask between the lip and the alveolar ridge, which is also useful in the edentulous. 4 

Facial hair also has been reported to be a cause of difficult intubation because of a handlebar moustache obscuring the view of the larynx. The solution in this case was to force the moustache flat with adhesive tape. Reflection on these anesthetic problems has made me decide to invest in a new razor.

Johnson JO, Bradway JA, Blood T: A hairy situation (letter). A NESTHESIOLOGY 1999; 91:595
Alexander R, Thomas DI: Overcoming the beard (letter). Anaesthesia 1999; 54:100
Vincent C, Ames WA: The bearded airway (letter). Anaesthesia 1998; 53:1034–5
Crooke J: The bearded airway (letter). Anaesthesia 1999; 54:500