10A - Airway Approach Algorithm

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Last updated 3:56 AM on 4/13/26
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17 Terms

1
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  1. Is Airway control required

  • type of surgery

  • patient preference

  • surgeon preference

  • anestheologist preference

YES - Next Question

NO - procedural sedation

  • regional anesthesia

  • may need slight manipulation of airway to some degree or convert to GA

2
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  1. WIll direct larygoscopy be difficult - predictors

  • clinical experience

  • previous history of difficult intubation

  • variation in normal anatomy

  • pathologic conditions

  • diagnostic tests - radiography

  • physical evaluation of airway

    • LEMON

YES - Cannot intubate next question

NO - Asleep intubation

3
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LEMON

look externally

evaluate 3 3 2 rule

mallampti score >= 3

obstruction

neck mobility limited

4
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<p>what mallampati is this </p>

what mallampati is this

Class 1: soft palate uvuale facue, pillars visible , no diffculty

5
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<p>what mallampti score </p>

what mallampti score

class 2: soft palate, uvula facuses visible no difficulty

6
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<p>what mallampati score </p>

what mallampati score

class 3 soft palate base of uvula moderate difficulty

7
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<p>what mallampati is this </p>

what mallampati is this

CLass 4, hard palate only visible severe difficult

8
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<p>Cormack -Lehane classificaition </p>

Cormack -Lehane classificaition

Grad 1 - 4

9
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  1. CAn supraglottic device be used

face mask ± oral/nasal airway

LMA

YES- cannot intubate, can ventilate

NO - awake intuabtion, canot ventilate

10
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Face mask predictors

OBESE

persistant and prolonged failed intubated attempts can cause progressive difficulty in face mask ventilation

11
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OBESE law

obstruction / obese

bearded

elderly (>55year old)

stiff lungs/snorer

edentulous

12
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LMA predictors for difficult ventilation

RODS

13
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RODS

restricted mouth opening

obstruction

disrupted airway

stiff lungs

14
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  1. is the stomach empty

  • non- fasting

  • poorly manage GERD

  • delay gastric emptying

  • blunted gag reflex

SHOULD NOT be ventilated supraglottic device

NO - cannot intubate, should ventilate

YES - cannot intubate can ventilate

15
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  1. WIll patient tolerate an Apenic period

  • Anesthesia induction may produce an apneic period of:

    • 30 - 60 sec with succ

    • 4 -7 mins with succ

  • Preoxygenation

    • tidal breathing for 3 -5 mins on 100% O2

    • FOUR deep VC breaths at 100% oxygen taken within 30 seconds

    • allow patient to tolerate a longer apenic period

16
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factors that contribute to premature desaturations

  • pregnancy

  • disease

  • obesity

  • inadequate preoxygenation

17
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WIll patient tolerate apneic period

Yes - sleep intubation

no - awake intubation