Management of Airway

Question 1

Routine airway management: (8)

Answer 1

• preanesthetic assessment
• preparation/ equipment check
• patient positioning
• preoxygenation
• bag mask ventilation
• intubation or LMA
• confirmation of placement
• extubation

Question 2

Standard Preanesthetic Airway Assessment

Answer 2

1. Mouth Opening: 3cm incisor opening
2. Thyromental distance: 3 fingerbreaths
3. Neck Circumference: >17in associated with difficult airway
4. Prominent overbite, neck ROM, shape of palate
5. Mallampati: size of tongue relation to oral cavity- more pharyngeal structures are obstruction more difficult intubation

Question 3

Mallampati Class I

Answer 3

palatal arch including bilateral faucial pillars is visible down to base

Question 4

Mallampati Class II

Answer 4

upper part of faucial pillars and most of uvula are visible

Question 5

Mallampati Class III

Answer 5

only soft and hard palate are visible

Question 6

Mallampati Class IV

Answer 6

Only hard palate is visible

Question 7

Skills to think about (4)

Answer 7

Bag/mask
Direct larnygoscopy/video laryngoscopy
Supraglottic airway ventilation
Cricothyrotomy airway placement

Question 8

Indications of Difficult Bag Mask

Answer 8

Seal impeded (beard, NGT)
Obstruction of upper or lower airway
Obesity
>55 yrs
Absence of teeth
Decreased lung elasticity 
OSA

Question 9

Indications for Difficult Larnygoscopy

Answer 9

3-3-2
III & IV mallampati
Obstruction upper airway
Obesity
Scarring,radiation,masses of neck
Neck mobility

Question 10

Indications of Difficult Supraglottic Airway Device Placement/Ventilation

Answer 10

Restricted mouth opening
Obstruction of upper airway
Distortion of airway anatomy
Stiff lungs

Question 11

Indications of Difficult Cricothyrotomy

Answer 11

Distortion of neck anatomy
Obesity or short neck
Trauma in area
Halo device, fixed flexion
Surgery causing limited access