Which of the following are the most significant predictors of difficult airway?
They stated that the 4 following factors were significant: TAS, the Mallampati classification, the thyromental distance, the head and neck movement, and the past history of difficult endotracheal intubation.
Is it harder to intubate a fat person?
Incidence of difficult intubation in obese is 11% and 7% in lean. Obese patients are difficult to mask ventilate and slightly more difficult to intubate than lean patients but have no difference regarding laryngoscopy. Age >40 years and sternomental distance <12.5 cm are predictors of difficult intubation in obese.
Are there any other considerations when intubating a morbidly obese patient?
Morbidly obese patients are at increased risk of difficult mask ventilation and intubation as well as increased risk of hypoxemia during tracheal intubation.
Does the airway examination predict difficult intubation?
The Shiga 2005 systematic review and meta‐analysis of six airway screening tests found that “the clinical value of bedside screening tests for predicting difficult intubation remains limited”. Nevertheless, an airway physical examination is still recommended (ASA 2003; ASA 2013).
How do you measure Sternomental distance?
Sternomental distance (SMD): It is defined as the distance from the suprasternal notch to the mentum and is measured with the head fully extended on the neck and the mouth closed.
What is ramp position?
In the ramp position, the patient’s head and torso are elevated such that the external auditory meatus and the sternal notch are horizontally aligned (black line).
How do you know if intubation is difficult?
A reduction in space (<5 mm) between the C1 spinous process and the occiput, seen on a lateral neck radiograph taken in a neutral position, is recognized as an indicator of difficult intubation.
What is the optimal position to intubate a morbidly obese patient?
To the Editor: (1) report a series of 100 patients in which 99 were successfully tracheally intubated using an elevated head-up position (Fig. 1) (2). In this position, the shoulders are elevated with several pads, the head and neck are extended, and the external auditory meatus is in line with the sternal notch.
What is the normal Thyromental distance?
The thyromental distance—the distance from the anterior larynx (neck) to the mandible (chin)—is a predictor of difficult intubation. Generally, a thyromental distance of greater than or equal to 3 cm or the width of 3 fingerbreaths is acceptable.