What is the most common reason for a difficult intubation?

What is the most common reason for a difficult intubation?

The main factors implicated in difficult endotracheal intubation were poor dental condition in young patients, low Mallampati score and interincisor gap in middle-age patients, and high Mallampati score and cervical joint rigidity in elderly patients.

What factors predict a difficult intubation?

They stated that the 4 following factors were significant: TAS, the Mallampati classification, the thyromental distance, the head and neck movement, and the past history of difficult endotracheal intubation.

What indicates a difficult airway?

ASA practice guidelines “a difficult airway is defined as the clinical situation in which a conventionally trained anesthesiologist experiences difficulty with face mask ventilation of the upper airway, difficulty with tracheal intubation, or both”.

How common is difficult intubation?

The prevalence of difficult intubation varies widely from 0.1% to 10.1% depending on the definition used [2,3]. There have been many definitions and methods to describe or predict difficult intubation, but predicting difficult intubation is difficult with low sensitivity and specificity [4,5].

What to do if you can’t intubate?

Recent strategies to deal with ‘cannot ventilate, cannot intubate’ situation include multiple new alternative airway devices like Laryngeal Tube and ProSeal Laryngeal Mask Airway (LMA). In the “can’t intubate, can’t ventilate” scenario, cricothyrotomy can be a life-saving procedure.

Which Mallampati score would predict a very difficult intubation?

A high Mallampati score (class 3 or 4) is associated with more difficult intubation as well as a higher incidence of sleep apnea.

Does the airway examination predict difficult intubation?

The Shiga 2005 systematic review and meta‐analysis of six airway screening tests found that “the clinical value of bedside screening tests for predicting difficult intubation remains limited”. Nevertheless, an airway physical examination is still recommended (ASA 2003; ASA 2013).

How do you handle difficult intubation?

In case of failure, several options are available: (a) establishment of a surgical airway, (b) postponing the intervention, with a new attempt at awake intubation under better conditions, (c) general anaesthesia is induced and maintained by facemask, (d) tracheal intubation is attempted after the induction of general …

What is the ASA difficult airway algorithm?

The Difficult Airway Algorithm of the American Society of Anesthesiologists (ASA) was developed to guide clinicians in the management of the patient who is either predicted to have a difficult airway or whose airway cannot be adequately managed after induction of anesthesia (1).

What is Cannot intubate Cannot ventilate?

Cannot intubate, cannot ventilate (CICV) is one major cause of death associated with general anesthesia and thus proper airway management plans are necessary. To achieve safe airway management, it is necessary first to predict if the patient’s trachea can be difficult to intubate or the lungs difficult to ventilate.

What happens if intubation fails?

When intubation has failed, face mask ventilation or LMA insertion may be difficult due to decreasing depth of anaesthesia and incomplete muscle relaxation. In this situation, the patient may not be sufficiently awake to spontaneously ventilate or deep/paralysed enough for ventilation to be effectively provided.

Which of the following is the best predictor of a difficult intubation in a morbidly obese patient *?

[15] used ultrasound to quantify neck soft tissue at the level of the vocal cords and suprasternal notch and demonstrated that, in an obese population, the best predictor of difficult intubation was distribution of fat in these areas.