Airway Assessment

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Figure 3. The mechanism of laryngoscopy and tracheal intubation by a midline video laryngoscope demonstrated with an Airtraq TM superimposed on a magnetic resonance scan of head and neck in neutral position. The red line indicates the primary and secondary curves. The black arrow represents the line of sight from the distal end of the device to the glottis. Figure 4. Impaction of the ETT tip on the anterior subglottic wall. 52 Airway Assessment
Figure 5. Passage of a bevel-tipped ETT through the glottis with an accentuated secondary curve. The C-Mac video laryngoscope TM has blades designed to either follow (the “Dorges” or D blade) or compress the airway curves (the modified Macintosh blade). Use of the modified Macintosh blade in patients with posterior column pathology permits flattening of the primary and secondary curves, with the benefit of video-assisted glottic visualisation from further along the primary curve. Consequently, the operator may need to apply less force to visualise the glottis compared to a standard Macintosh blade. The C-Mac TM should improve intubating conditions compared to contouring video laryngoscope blades, due to flattening of the secondary curve (anti-clockwise rotation of the laryngeal vestibule axis). The application of this device is intuitive, and it is recommended to operators with infrequent exposure to video laryngoscopes. The Classic LMA TM (cLMA, LMA North America, Inc, US) with fibreoptic bronchoscope/Aintree Intubating Catheter TM18 (AIC; Cook Critical Care, US), intubating laryngeal mask 19-21 and flexible fibreoptic intubation are other possible alternatives. Intubation can be assisted via the placement of a Classic LMA TM in the extraglottic region, permitting oxygenation +/- ventilation. Subsequently, a fibreoptic bronchoscope loaded with an AIC TM is inserted through the LMA until the glottis is visualised (Figure 6). Once the AIC TM positioned in the trachea under fibreoptic vision, the cLMA TM and the bronchoscope are removed. Intubation with an ETT over the AIC TM is facilitated with a curved-blade laryngoscope to flatten the primary and secondary curves. 53 Airway Assessment
Page 1 and 2: Airway Assessment Authors: Dr Pierr
Page 3 and 4: Part 1. Introduction This airway as
Page 5 and 6: REFERENCES 1. Yentis SM. Predicting
Page 7 and 8: SUMMARY Preoperative airway assessm
Page 9 and 10: Table 3. Difficult airway screening
Page 11 and 12: PREDICTORS OF DIFFICULT BAG-MASK VE
Page 13 and 14: INCIDENCE OF IMPOSSIBLE MASK VENTIL
Page 15 and 16: DIFFICULT ENDOTRACHEAL INTUBATION D
Page 17 and 18: Figure 1. A 100 per cent POGO score
Page 19 and 20: When the patient has risk factors,
Page 21 and 22: TONGUE ABNORMALITIES Direct laryngo
Page 23 and 24: Class A B C Position of the lower t
Page 25 and 26: Table 18. Wilson risk sum score. Wi
Page 27 and 28: Table 20. Arne risk index. Risk fac
Page 29 and 30: fibreoptic intubation has a finite
Page 31 and 32: 8. Practice guidelines for manageme
Page 33 and 34: 46. Samsoon GL, and Young JR. Diffi
Page 35 and 36: 86. Komatsu R, et al. Ultrasound qu
Page 37 and 38: RE-EXAMINING THE FOUNDATIONS OF AIR
Page 39 and 40: Figure 3. Stylised orientatation of
Page 41 and 42: Figure 5. Retrognathic patient (lef
Page 43 and 44: POSTERIOR COLUMN The original descr
Page 45 and 46: It is postulated that any reduction
Page 47 and 48: 7. Chou HC, Wu TL. A reconsideratio
Page 49 and 50: CHANGING THE PARADIGM: THE NEXT STE
Page 51: Compression of submandibular struct
Page 55 and 56: Figure 7. Predicted alteration in p
Page 57 and 58: Figure 9. Accentuation of primary a
Page 59 and 60: LARYNGEAL MASK-FACILITATED INTUBATI
Page 61 and 62: 17. Sanuki T, Sugioka S, Hirokane M
Page 63: 54. Law-Koune JD, Liu N, Szekely B,

Airway Assessment

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