Geriatric Airway Management

Question 0

In regards to arthritis what should we be looking for with our preop evaluation

Answer 0

1) Cervical spine you’re looking forward limited range of motion—caution with C-spine especially with extension
2) with TMJ you looking for limited mouth opening
3) with cricoarytenoid joint you looking for vocal changes such as hoarseness

Question 1

What are some of the problems related to in regards to aging

Answer 1

1) Arthritis. (Cervical spine- Atlantooccipital joint, cricoarytenoid, joint temporomandibular joint)
2) Chestwall and lung compliance (Muscle loss, loss elastic recoil, Decreased vital capacity)
3) dentition
4) osteoporosis
5) senility (Reliability, Corporation)
5) Coexisting upper airway diseases (I.e. Lung cancer)

Question 2

What is our concern with Chestwall and lung compliance in the elderly patient

Answer 2

Decreased ability to Cough and to protect airway

caution during emergence

Question 3

What’s the concern with dentition in the elderly patient

Answer 3

Most elderly patients are edentulous which causes :

1) difficult mask fit
2) decreased ability to seal for positive pressure ventilation

use adjuncts such as oral airway And face mask strap

Question 4

Why does osteoporosis present concerns in the elderly patient during surgery

Answer 4

Increased risk of fracture

Question 5

Why is Senility a concern with the elderly patient

Answer 5

1) poor historians - use alternate sources for history
2) Corporation is a consideration- there’s increased safety risk
3) minimize sedation in the elderly to avoid delay emergence and delirium

Question 6

How do coexisting diseases in the elderly impact surgery

Answer 6

Due to the age of the patient there’s increased coexisting disease risk — obtain thorough history for tobacco & alcohol use