Airway Assessment Flashcards
What are the Indications for a mask case?
1) No instrumentation of airway required
●Therefore will avoid trauma, CV stimulation
2) Difficult airway not present
3) Surgeon does not need access to head/neck (BMT-ok)
4) No airway bleeding/secretions
5) Case of short duration
6) No table position changes- head available
7) Ventilation by mask requires the ability to achieve a seal between the mask and face to overcome upper airway obstruction. Obstruction should be easily relieved with airway/ chin lift
What are the indications for intubation?
1) Airway protection
2) Maintenance of patent airway
3) Application of positive pressure ventilation
4) Maintenance of adequate oxygenation
5) Deliver predictable Fio2
6) Provide positive end-expiratory pressure
What are some co-morbidities that may effect airway management?
1) Lesions of larynex
2) Thyroid disease
3) Cancer
4) GERD
5) Diabetes
6) Sleep Apnea
7) Obesity
8) Genetic Disorders
9) Rheumatoid Arthritis
10) Musculoskeletal
11) Scleroderma
What does Standards I and III of the AANA states about pre-op evaluation?
Examination of the Airway to predict difficulty with mask ventilation and intubation is an essential component of the pre-operative assessment for patients who are undergoing surgery.
What does Standards I of the AANA states about pre-op evaluation?
Standard I - a practitioner shall perform a thorough and complete pre-anesthesia assessment, allowing the practitioner to (Standard III) formulate a patient-specific plan for anesthesia care
What is the normal mouth opening?
normal > 4 cm or > 2 fingerbreadths
What is thyromental distance and what is the normal thyromental distance?
–Distance from mandible to prominence of thyroid cartilage (thyro-mental) normal 6.5 cm (50 mm); 3 fingerbreadths (3FB)
What is hyoidmental distance and what is the normal distance?
–Distance hyoid to mandible (hyoid-mental); normal 2FB
What are some strong predictors of difficult airway?
1) Obesity
2) Decreased head and neck movement
3) Decreased jaw movement
4) Receding mandible
5) “buck teeth”
What are the contents of the portable storage unit for difficult airway management?
1) Rigid laryngoscopy blades of alternate design and size from those that are routinely used
2) ETT of assorted sixes
3) ETT guides such elastic gum bougie, semi-rigid stylet, forceps
4) Various supraglottic airway devices such as laryngeal mask airways in a variety of sizes and combitudes
5) Fiberoptic intubation equipment
6) Retrograde intubation equipment
7) Equipment for transtracheal jet ventilation
8) Equipment suitable for emergency surgical airway access such cricothyrotomy
9) Exhaled carbon dioxide detector.
What should you include in the pre-op documentation?
1) dental
2) cervical range of motion
3) Mallampati class
4) TM distance
5) mouth opening
What should you include in the post-intubation documentation?
1) visualization
2) trauma
3) equipment used
4) hemodynamic or respiratory changes
What should you include in the post-extubation documentation?
1) loose teeth intact
2) airway patency
3) adjuncts airway maneuvers used
