S2E4 - Airway Management

Check out this great video which summarizes the steps below: https://www.youtube.com/watch?v=8AOB2PtHfVM&ab_channel=InterAnestHere are a few key steps in airway management: Ask yourself: Will I be able to mask ventilate?Will I be able to perform laryngoscopy, directly or indirectly?Will I be able to intubate this patient?Is there a significant aspiration risk?History and physical:Check your patients' anesthetic history for any record of a previously difficult airway.Difficult bag-mask - BONES: beard, obesity, no teeth, elderly, snoring (or OSA)Mouth opening & Mallampati score (high score = difficult laryngoscopy!)Thyromental distance (see below) and sternomental distanceMobility at the temporomandibular joint and prognathism Managing the airway:Pre-oxygenate patient to end-tidal O2 of >80%Align the oral/pharyngeal/laryngeal axes via the "sniffing position"Helpful tip! Place folded sheets, rolled blankets or a foam headrest underneath patients' neck to help achieve this position. Hold your Mac blade in your left hand; advance the blade to the vallecula while sweeping the tongue out of the wayApply pressure up to the corner of where the wall/ceiling meet to reveal the glottic opening and visualize the cordsDescribe the view of the cords using the Cormack-Lehane scale! If you can't see the cords, use the BURP maneuverStop advancing the tube when you see the proximal end of the endotracheal tube is at 21-22 cm at the front teeth in an adult - then ask for the cuff to be inflatedConfirm tube placement:Auscultate for breath soundsCheck capnographyLook for symmetric rise and fall Celebrate with a little happy dance (in your head)Support the show

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