Difficult Airway Flashcards
Major changes to most recent update to DAA include…
- beware passage of time
- limit attempts
- oxygen saturation
*human factors incorporated throughout
4 elements of decision making and planning for the DA
1) risk of difficulty with laryngoscopy and intubation?
2) suspected difficult face mask or SGA?
3) increased r/f aspiration?
4) increased r/f rapid desat?
Evaluation of an airway has 2 components…
1) airway risk assessment
2) airway physical exam
Predictors of difficult laryngoscopy
- limited mouth opening
- limited mandibular protrusion
- decreased TMD
- Mallampati 3 or 4
- limited head/neck extension
- increased neck circumference
Mnemonic for difficult laryngoscopy
LEMON
Predictors for difficult VAL
- cormack grade 3 or 4
- abnormal neck anatomy
- limited mandibular protrusion
- decreased TMD
- decreased sterno-thyroid distance
Mnemonic for difficult VAL
CRANE
Predictors for difficult bag-mask ventilation
- high BMI
- limited mandibular protrusion
- decreased TMD
- Mallampati 3 or 4
- edentulous
- beard
- OSA
- hx of neck radiation
Mnemonic for difficult BMV
ROMAN
Predictor of difficult SGA
- decreased mouth opening
- glottic or subglottic pathology
- fixed Cspine flexion deformity
Mnemonic for difficult SGA
RODS
Most significant clinical predictor of difficult mask ventilation
radiation to the head and neck
Mnemonic for difficult surgical airway
SHORT
What is a critical decision point in any DAA?
ability to ventilate/oxygenate
Yes? nonemergency pathway
No? emergency pathway
First option if you find yourself in a cannot ventilate situation
SGA
