Difficult Airway

by Brian Warriner, MD

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    So we're now going to talk about my nightmare and the nightmare of virtually every anesthesiologist. And that's the failure to secure the airway, because this can lead to death, can lead to immediate cardiac arrest, and it can lead to permanent brain damage, chronic vegetative states, from cerebral hypoxemia. This is the single most important aspect of the anesthesiologist's job. And really, it's what we get paid for. If we fail in this respect, we failed in every respect, because obviously, if the patient doesn't survive the anesthetic, having surgery is kind of a waste of time. We're going to talk more about standard intubation techniques and techniques used in the difficult airway situation, in Lecture 5, under General anesthesia. But some of the warning signs, just to give you a preview of what's going to happen, include poor mouth opening; normally a mouth should open 5 - 6 centimeters, but if it only opens less than 2 - 3 centimeters, that's a warning sign. Poor neck mobility. So, the inability to extend the neck is a major concern and it's common in elderly people. So we see it a lot. Small or deformed mandible. This can happen in congenital anomalies, it can happen with damaged mandibles, it can happen with people who have very poor dentition, and have a large overbite and a poorly developed mandible as well. We mentioned we measure the mento-thyroid distance, which is the distance from the tip of the chin to the thyroid cartilage, which is the large cartilage in the neck, the airway. And if it's less than 4 centimeters, we know we may have a problem. Short, thick neck can be a problem. Fixed flexion deformity of the neck, as seen in some diseases such as ankylosing spondylitis, and anything that...

    About the Lecture

    The lecture Difficult Airway by Brian Warriner, MD is from the course Anesthesiology: Introduction. It contains the following chapters:

    • The Difficult Airway
    • If You Can Not Intubate
    • If You Can Not Intubate and Ventilate
    • My Technique

    Included Quiz Questions

    1. Small mouth, flexion deformity of neck, small or deformed mandibe.
    2. Clicking of the temporal-mandibular joing.
    3. Slight reduction of neck flexion.
    4. A family history of difficult airway.
    1. Can’t intubate, can’t ventilate.
    2. Can’t intubate, can’t expirate.
    3. Can’t intubate, can’t maintain BP.
    4. Surgeon anger..

    Author of lecture Difficult Airway

     Brian Warriner, MD

    Brian Warriner, MD

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