Airway Management Flashcards
What steps should be taken if having difficulty with BMV?
- reposition head and neck into a sniffing position
- If tongue or airway soft tissue is cause of obstruction, place an oral airway
- If ventilation still inadequate, anesthetist should preform two-handed mask ventilation
What are the hallmark signs of an upper airway obstruction in the unanesthetized patient?
- hoarse or muffled voice
- difficulty swallowing secretions
- stridor
- dynes
What are signs of lower airway obstruction?
- high peak airway pressures
- low tidal volumes
- impaired ventilation
What is a predictor of difficult mask ventilation?
- obstructive sleep apnea
- snoring
*significant obesity has been identified as a potential risk factor of difficult BMV
What is direct laryngoscopy?
The process of airway instrumentation with a laryngoscopes in order to acquire direct line of sight with the laryngeal opening.
Preformed prior to placing the ET tube. First step of intubation procedure
What is direct tracheal intubation?
The process of placing an ET tube into the trachea proximal to the carina
What is ASA definition of “difficult to ventilate”
-when signs of inadequate ventilation can not be reversed by mask ventilation or the patient’s oxygen saturation can not be maintained above 90% with mask ventilation.
Definition of difficult to incubate
-a trained anesthesia provider, using conventional laryngoscopy, requires more than 3 attempts or more than 1 0 minutes to complete tracheal intubation.
What percentage of difficult airways are picked up with proper pre-op veal?
15-50%
What are causes of difficult intubation not related to the patien?
- Inadequate pre-op assessment
- malfunctioning equipment
- not skilled anesthetist
- experienced assistance
What is the Lemon Law?
-Look externally
- Evaluate the 3-3-2 rule
- Mallampati
- Obstruction?/Obesity
- Neck mobility
What is the 3-3-2 Rule?
3: minimal distance the mouth should open
3: distance from the tip of mandible to the laryngeal cartilage
2: distance from the floor of the mouth to the prominence of the laryngeal cartilage
*measured in finger
What angle is used to measure neck mobility?
Atlanto-occipital angle
What is the thyro-mental distance?
Measure from upper edge of thyroid cartilage to chin with head fully extended
A short distance = an anterior larynx
> 7cm is usually easy intubation
<6cm is difficult airway
What does the BONES acronym assess for?
Is mask ventilation going to be difficult
Beard Obesity No teeth Elderly Snoring
