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miércoles, 25 de enero de 2017

Assessing Airways in the ED

PonderingEM - January 25, 2017 - By Andrew Wilkinson
"I’m an anaesthetic registrar in North East London. On a daily basis I perform airway assessments. Although not a classic medical school patient examination, it’s an extremely important process. Fortunately it’s very simple, and in this blog I’d like to highlight why it’s important, and some concepts to think about when dealing with a patient that might require a definitive airway in the ED....
The assessment
Like any patient assessment it can be neatly divided into history, examination and investigations. In the ED, I can appreciate that history and investigations are not always available, but that’s OK because the crucial component of an airway assessment is the physical examination. Virtually all of the information is gained visually.
It is made up of multiple single assessments:
  • Mallampati score (I,II,III,IV)
  • Mouth opening (>3cm is good)
  • Thyromental distance (>6.5cm is good)
  • Dentition
  • Mandibular protrusion/upper lip bite test
  • Neck movements