Chapter 38: The Geriatric Airway Flashcards
In ages > 80, we see patients with:
Chronological age (osteoporosis, neurological damages), coexisiting disease, surgical procedures
At what age group do coexisting disease and surgical procedure become common?
65-80
Arthritis is most commonly present in which parts of the body?
Cervical spine
Cricoarytenoid joint
Temporomandibular joint
What are some characteristics of the chest wall and lungs of the elderly?
Muscle loss
Stiffer chest wall
Decreased lung elastic recoil
Decreased vital capacity
Effect of age on FRC?
FRC unchanged with increasing age.
Why are we worried about the fact that patients over 80 are more prone to osteoporosis?
There is increased fracture risk associated with manipulating the head and the neck.
Describe the problems that arthritis of the cervical spine in the older patient may cause us in establishing an airway:
The patient will have a limited ROM; we should be prepared to handle a patient with no movement of O-A joint at all (no extension).
Describe the problems that arthritis of the TMJ in the older patient may cause us in establishing an airway:
Limited mouth opening–have alternative ready in case TMJ issues get in the way.
Describe the problems that arthritis of the cricoarytenoid joint in the older patient may cause us in establishing an airway:
It may cause voice change or hoarseness, and that’s something that we need to document preop so no one can claim that it occurred post-op.
How does age effect ability to cough? Why does that matter?
The elderly have a decreased ability to cough/protect their airway–be careful during emergence.
Why does it matter to us that the elderly have loose skin?
It is more difficult to get a mask fit and seal for PPV; use a face mask strap + oral airway if need be.
There is an increased risk of cancer with age: what two habits do you want to ask your patients about?
Tobacco use
Alcohol use
