Lesson 3

Cormack and Lehane Grading System

• A system to measure laryngoscopic view during direct laryngoscopy.

Grading Levels

• Grade 1: Complete or nearly complete view of the glottic opening.
• Grade 2A: Posterior region of the glottic opening visible.
• Grade 2B: Corniculate cartilages and posterior vocal cords visible (no glottic opening).
• Grade 3: Epiglottis only visible.
• Grade 4: Soft palate only visible.

Intubation Correlation

• Grade 1 & 2A: Easier intubation.
• Grade 2B & 3: Harder intubation (consider using a bougie).
• Grade 4: Requires an alternative approach for intubation.

Additional Notes

• In modifications, Grade 2A represents visibility of the posterior glottic opening.
• Grade 2B may also be described in terms of visibility of the arytenoids if corniculate cartilages are not mentioned.