Management of Airway Flashcards
Routine airway management: (8)
- preanesthetic assessment
- preparation/ equipment check
- patient positioning
- preoxygenation
- bag mask ventilation
- intubation or LMA
- confirmation of placement
- extubation
Standard Preanesthetic Airway Assessment
- Mouth Opening: 3cm incisor opening
- Thyromental distance: 3 fingerbreaths
- Neck Circumference: >17in associated with difficult airway
- Prominent overbite, neck ROM, shape of palate
- Mallampati: size of tongue relation to oral cavity- more pharyngeal structures are obstruction more difficult intubation
Mallampati Class I
palatal arch including bilateral faucial pillars is visible down to base
Mallampati Class II
upper part of faucial pillars and most of uvula are visible
Mallampati Class III
only soft and hard palate are visible
Mallampati Class IV
Only hard palate is visible
Skills to think about (4)
Bag/mask
Direct larnygoscopy/video laryngoscopy
Supraglottic airway ventilation
Cricothyrotomy airway placement
Indications of Difficult Bag Mask
Seal impeded (beard, NGT) Obstruction of upper or lower airway Obesity >55 yrs Absence of teeth Decreased lung elasticity OSA
Indications for Difficult Larnygoscopy
3-3-2 III & IV mallampati Obstruction upper airway Obesity Scarring,radiation,masses of neck Neck mobility
Indications of Difficult Supraglottic Airway Device Placement/Ventilation
Restricted mouth opening
Obstruction of upper airway
Distortion of airway anatomy
Stiff lungs
Indications of Difficult Cricothyrotomy
Distortion of neck anatomy Obesity or short neck Trauma in area Halo device, fixed flexion Surgery causing limited access