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31 Cards in this Set
- Front
- Back
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LEMON |
look externally, evaluate, mallampati score, obstruction, neck mobility |
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MOANS |
mask seal, obesity, age, no teeth, stiff lungs |
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SHORT |
surgery, hematoma or infection, obesity, radiation, tumor |
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difficult Interincisor distance |
3cm or less (1.5 fb) |
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difficult thyromental distance |
6cm or less (3 fb) |
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3-3-2 rule |
three fingers mouth opening, three fingers between mentum and hyoid bone, two fingers between hyoid and thyroid cartilage |
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Sternomental distance |
less than 12.5 cm difficult intubation |
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Mallampati I |
soft palate, tonsillar fauces, tonsillar pillars, uvula visualized |
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Mallampati II |
soft palate, tonsillar fauces, uvula visualized |
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Mallampati III |
soft palate, base of uvula visualized |
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Mallampati IV |
soft palate not visible |
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Cormack and LeHane Grade 1 |
most of glottis is seen |
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Cormack and LeHane Grade 2 |
only posterior part of glottis seen |
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Cormack and LeHane Grade 3 |
epiglottis visible but no glottis (maybe use stylet) |
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Cormack and LeHane Grade 4 |
not even epiglottis is visible |
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Normal neck flexion |
chin to chest |
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normal neck extension |
35 degrees from neutral position |
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Four D's of difficult airway |
dentition (prominent upper incisors, receding chin) distortion (edema, blood, vomit, tumor, infection) disproportion (short 3-3-2, bull neck, large tongue, small mouth) dysmobiity |
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diabetic stiff joint syndrome ... what is the sign? |
makes intubation difficult for long term type I diabetics ... can involve atlanto-occiptal joint and fourth and fifth proximal pharyngeal joints ... prayer sign |
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External assessment in pregnancy |
does not reliably predict difficult intubation |
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Why is parturient considered full stomach? |
upward displacement of stomach by uterus, loss of esophageal sphincter tone due to progesterone, gastric emptying delayed |
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What is considered obese? |
BMI > 30, 20% over ideal weight; 100% over ideal is morbidly obese |
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Why is obesity bad? |
decreased chest wall compliance, small tidal volumes leading to atelectasis >> rapid desaturation when apnea occurs due to decreased functional residual capacity and pulmonary oxygen stores. |
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Airway difficulties during pregnancy |
full stomach, airway edema (pre-eclamptic), airway closure when supine, large breasts |
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failed intubation |
failure to intubate after multiple attempts |
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difficult intubation |
3 or more attempts required |
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difficult laryngoscopy |
cannot visualize any portion of cords with conventional laryngoscopy |
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position of head in sniffing position |
elevated 10cm (4in), neck flexed toward chest and extended at atlanto-occipital joint ... laryngeal and pharyngeal axes are aligned |
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BURP tecnique |
laryngoscopist does cricoid pressure with right hand, then assistant takes over freeing up had for intubation |
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Tube sizes by age |
less than 8 = uncuffed ETT 9-11 = 7mm cuffed 14 to adult = 7-8mm cuffed adult female = 7-8mm cuffed adult male = 7.5-8.5mm cuffed |
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How much cricoid pressure? |
30-44 N or 6.75-9.9 pounds |
