NextGen Learning To Elevate Your Airway Practice
Overview
When stepping up to the head of the bed, In a rapidly evolving emergency, it may be hard to fully assess the airway of that altered or agitated patient with the same detail as you would for an elective pre-operative assessment. However, the skilled clinician should still be able to quickly and efficiently get some of the most important information they need by doing a few simple things. Things that you should learn and incorporate into your own practice. They only take seconds and can sometimes be the difference between success and failure. Here they are.
Rapid Review
Except in a few circumstances, you can always check mouth opening and cervical mobility and palpate the neck. These are the essential elements of the rapid airway assessment, which can be done in under 60 seconds.
With More Time (& a Co-operative Patient)
Many other assessment tools used to evaluate the airway before intubation require more time and a cooperative patient. For the subset of patients who need urgent intubation but may still be able to partially cooperate with an airway assessment, you will need to use clinical judgment. If the patient can maintain their oxygen saturations long enough to perform a more thorough assessment and there are no other time-critical elements to consider, you can incorporate some of the tools discussed below into your assessment. There is always a trade-off between the immediacy of intubation and the possible increased risk of unexpected difficulty. You will have to decide. In a trauma patient who needs to go to the operating room or the CT scanner, a rapid assessment to address other emergent reversible pathology may tip the scales toward a more rapid assessment.
Elements of the Assessment
The Mouth
Malampati
The Neck
Curated MedEd
If you have time, this great video is a comprehensive review of the key elements of a full airway assessment. Taken together, they provide an effective and complete assessment strategy. Watch, and then add this channel to your learning network.
What’s Next
FIND ME
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