Obesity Airway Management

Question 0

Case evaluation
Your next patient in the OR is a 44-year-old 5’1” 424 pound woman scheduled for laparoscopic exploration to rule out small bowel Obstruction. What are possible plan A and Plan B

Answer 0

Plan A
safety first attempt intubation success
1) Optimize patient position- Ramping - Create sternomental space
2) Provide complete pre-oxygenation because of the desaturate quickly

Plan B
Possible use of ETT introducer

Question 1

In dealing with obesity what is the most Important positioning techniques to increase the Sternomental space?

Answer 1

Reactions alignment for direct visualization of glottis

Oral axis
Laryngeal axis
Pharyngeal Axis

Question 2

What can be used to promote the opening of The sternomental distance

Answer 2

Ramping the patients by placing sheets under the shoulders to elevate the trunk

Question 3

What is the underlying goal of obesity airway management

Answer 3

Keep the patient oxygenated due to quick desaturation

Question 4

True or false. Except for excess of supraglottic soft tissue that is sometimes present most obese patients are Not easy to intubate when properly positioned

Answer 4

False. They are easy to Intubate

Question 5

How do you calculate BMI

Answer 5

Weight (kg)/meters^2

Question 6

The metabolic rate is proportional bodyweight so what Parameters are increased due to this?

Answer 6

1) Oxygen demand
2) CO2 Production
3) Alveolar ventilation

Question 7

What long volumes are affected by obesity

Answer 7

Decreases in:

1) FRC
2) ERV (Expiratory reserve volume)
3) Total lung capacity

Question 8

What is Pickwickian syndrome

Answer 8

AKA obesity hypoventilation syndrome

Extreme obesity characterized by hypercapnia, cyanosis induced polycythemia, right-sided heart failure, and somnolence. They often suffer from obstructive sleep apnea (OSA)