Airway Assessment

Figure 1. A 100 per cent POGO score corresponds to visualisation of the entire glottic
opening from the anterior commissure of vocal cords to the inter-arytenoid notch
between the posterior cartilages.
INTUBATION DIFFICULTY SCALE
Adnet 35 introduced an intubation difficulty scale. This may be useful for communicating the total
intubating difficulty and for researching the predictive power of a specific variable in identical
patient groups 32 .
Table 14. Intubation difficulty score (IDS).
Parameter
Number of attempts >1
Every additional attempt adds one point.
Number of operators >1
Each additional operator adds one point.
Number of alternative techniques.
Each alternative technique adds one point. Repositioning the patient, change of
materials (blade, ET tube, addition of a stylette), change in approach (nasotracheal/
orotracheal), or use of another technique (fibreoptic or intubation through LMA).
Cormack and Lehane grade – 1
Apply Cormack and Lehane grade for first oral attempt. For successful blind
intubation N4 = 0.
Lifting force required
Normal
Increased
Laryngeal pressure
None
Applied
Position of vocal cords during laryngoscopy
Abduction
Adduction
Total intubation difficulty score (IDS) = sum of all the scores.
Score
N1
N2
N3
N4
N5 = 0
N5 = 1
N6 = 0
N6 = 1
N7 = 0
N7 = 1
N1-N7
17 Airway Assessment