Airway Assessment Flashcards
What are the two attachments for the vocal cords?
thyroid cartilage and arytenoids
What types of patients require an airway assessment?
any patient receiving any type of anesthesia
What are the indications for intubation?
to provide PEEP
maintain airway patency
deliver predictable FiO2
maintain adequate oxygenation
What are the indications for a mask case?
no difficult airway
surgeon doesn’t need access to head/neck
no bleeding/secretion issues in neck/throat
short case
no table position changes
any tongue obstruction should be easily removed with head tilt/chin lift
What are examples of surgical history that may predict a difficult airway?
tracheostomy or scar from previous one
neck dissection
UVPP
cervical spine procedures
What are some examples of co-morbidities that can predict a difficult airway
NM disease cancer lesions on the larynx obesity GERD diabetes OSA genetic disorders (turner's, downs, etc.) rheumatoid arthritis thyroid disease
What are some considerations when inspecting the teeth?
length of incisors?
condition of teeth (missing, diseased, overbite)?
relationship of upper incisors to lower incisors?
dentures or implants?
What is a normal mouth opening distance?
2 fingerbreadths or 4 cm
What is a normal thyromental distance?
6.5 cm or 3 finger breadths
What is a normal hyoidmental distance?
2 finger breadths
How is full ROM of the neck described?
should be able to touch chin to their chest
90-165 degrees
What is visible in mallampati class 1?
faucile pillars, uvula, soft palate, hard palate
What is visible in a mallampati class 2?
uvula, fauces, hard and soft palate
what is visible in a mallampati class 3?
base of uvula, soft and hard palate
What is visible in a mallampti class 4?
hard palate only
What is required in an airway set up?
laryngoscope tongue depressor blades (2) ETT (2) stylet ETCO2 detector syringe suction ambu bag LMA oral and nasal airways in several sizes
What should you document pre-op?
dental assessment, ROM, mallampati class, TM distance, mouth opening
What should you document post extubation
dental assessment (teeth still intact), airway patency, adjunct airways required/used
What should you document post intubation?
visualization of the chords, trauma, equipment used, hemodynamic or respiratory changes
What are the components of an emergency airway cart?
rigid laryngoscope blades of different size and design ETT of different sizes varying types of ETT guides/stylets supraglottic airways, such as LMA or combitubes fiberoptic equipment retrograde intubation equipment transtracheal jet ventilation equipment surgical airway equipment ETCO2 monitor
