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The Airway

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Ravi Alagar
Ed Burdett
THE AIRWAY
SpR in Anaesthesia
the centre for
Anaesthesia
UCL
The airway always comes first
This talk…
• Airway anatomy
• Airway assessment
• Airway control
Airway Anatomy
• Oropharynx
Airway Anatomy
Airway Anatomy
• Larynx
Airway Assessment
• History
• Examination
History
• Previous difficulty
• Medical conditions
– RA
– Ankylosing spondylitis
– Congenital problems
• Head and neck tumours
• Previous surgery
Examination
• Sometimes it’s pretty
obvious…
Examination
•
•
•
•
•
Obesity
Short thick neck
Neck movement
Scars
Large breasts
Examination
• Jaw
– Receding mandible
– Protrusion
• Dentition
–
–
–
–
Loose teeth
Prominent upper teeth
Overbite
Dentures
Examination
• Beware the bearded man…
Examination
• Mouth opening
• Bad if <3cm
• Mallampati
Examination
• Thyromental distance
• Bony point on mentum (mandible) to thyroid
notch
• Bad if short (<6cm)
A little preparation goes a long way…
Plan
Equipment
Help
Mask Ventilation
Difficulty mask ventilating
•
•
•
•
•
Age >55
BMI >26
History of snoring
Lack of teeth
Beard
Mask Ventilation
• Two-handed technique
Use adjuncts
Adult male
Adult female
The Airway
• Endotracheal tubes
Laryngeal mask (LMA)
The secure airway is a cuffed tube in the
trachea
LMA
Sometimes it can be difficult
Thank you
Any questions?
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