The Simplified Predictive Intubation Difficulty Score: a new weighted score for difficult airway assessment

2009 ◽  
Vol 26 (12) ◽  
pp. 1003-1009 ◽  
Author(s):  
Joël LʼHermite ◽  
Emmanuel Nouvellon ◽  
Philippe Cuvillon ◽  
Pascale Fabbro-Peray ◽  
Olivier Langeron ◽  
...  
Keyword(s):  
Difficult Airway ◽  
Intubation Difficulty ◽  
Airway Assessment ◽  
Weighted Score ◽  
Difficulty Score

scholarly journals Short Neck, a new criterion for airway assessment A pilot, cohort single blind study

2020 ◽  
Author(s):  
jafar faraj ◽  
Yasir E. Ahmed ◽  
Chetankumar B. Raval ◽  
Taisir M Yousif ◽  
Neeraj Kumar ◽  
...  
Keyword(s):  
Elective Surgery ◽  
P Value ◽  
Short Neck ◽  
Neck Length ◽  
Intubation Difficulty ◽  
Airway Assessment ◽  
Difficulty Scale ◽  
Group B ◽  
Difficulty Score ◽  
New Criterion

Abstract Purpose Short Neck is a term used by anesthesiologists to describe one of the risk factors for difficult airway management. However, the term Short Neck is very subjective and has not been standardized. We attempt to quantify Short Neck.Methods A pilot prospective single blinded study was conducted at Hamad General Hospital, Doha, Qatar between March 2018 and October 2018. 97 adult patients scheduled for elective surgery under general anesthesia were recruited. Measurements of airway assessment, including neck length, were documented prior to anesthesia. The operators (anesthesiologists) were blinded. Intubation Difficulty Scale was used. All data were documented and analysed afterwards. Patients were of three groups according to Intubation Difficulty Scale (IDS): Group A: IDS 0, Group B: IDS >0 - ≤5 and Group C: IDS >5.Results Five patients (5.2%) with intubation difficulty score >5 have a mean neck length 7.6 cm. Short Neck was found to have a significant p value 0.022 within the three groups.Conclusions Patient's features relevant to airway assessment are rather difficult to quantify. This is the first reported attempt to obtain an objective value for Short Neck in routine airway assessment.

scholarly journals A CASE REPORT- A CASE OF RIGHT SIDED ABSENT MAXILLA WITH ANTICIPATED DIFFICULT AIRWAY POSTED FOR PERINEAL URETHROPLATY

2020 ◽  
pp. 1-2
Author(s):  
Tanya Elizabeth Cherian ◽  
M. Sathyasuba
Keyword(s):  
Case Report ◽  
Difficult Airway ◽  
Urethral Stricture ◽  
Postoperative Recovery ◽  
Morbidity And Mortality ◽  
Video Laryngoscopy ◽  
Effective Management ◽  
Airway Control ◽  
Perioperative Morbidity ◽  
Airway Assessment

The key to success in patients with difficult airway is effective airway assessment and meticulous planning. Making use of simple and time-tested equipment and modifying these methods accordingly enable successful airway control avoiding perioperative morbidity and mortality . We report a case of 75 year old male with posterior urethral stricture planned for perineal urethroplasty with anticipated difficult airway. The airway was managed using video laryngoscopy and the procedure was uneventful with good postoperative recovery. This case report insists on making use of other conventional methods in the effective management of an anticipated difficult airway during a pandemic.

scholarly journals Difficult Airway Prediction Score for Intubation in Emergency Departments: A Retrospective Cohort Study

2021 ◽  
Author(s):  
Sorravit Savatmongkorngul ◽  
Panrikan Pitakwong ◽  
Pungkava Srichar ◽  
Chaiyaporn Yuksen ◽  
Chetsadakon Jenpanitpong ◽  
...  
Keyword(s):  
Emergency Department ◽  
Difficult Airway ◽  
Endotracheal Intubation ◽  
Difficult Intubation ◽  
Prediction Score ◽  
Care Hospital ◽  
Inclusion Criteria ◽  
Assessment Score ◽  
Airway Assessment ◽  
Lehane Grade

Abstract Objective: Difficult intubation is associated with an increasing number of endotracheal intubation attempts. Repeated endotracheal intubation attempts are in turn associated with an increased risk of adverse events. Clinical prediction tools to predict difficult airway have limited application in emergency airway situations. This study was performed to develop a new model for predicting difficult intubation in the emergency department.Methods: This retrospective study was conducted using an exploratory model at the Emergency Medicine of Ramathibodi Hospital, a university-affiliated super-tertiary care hospital in Bangkok, Thailand. The study was conducted from June 2018 to July 2020. The inclusion criteria were an age of ≥15 years and treatment by emergency intubation in the emergency department. Difficult intubation was defined as a Cormack–Lehane grade III or IV laryngoscopic view. The predictive model and prediction score for detecting difficult intubation were developed by multivariable regression analysis.Results: During the study period, 617 patients met the inclusion criteria; of these, 83 (13.45%) had difficult intubation. Five independent factors were predictive of difficult intubation. The difficult airway assessment score that we developed to predict difficult airway intubation had an accuracy of 89%. A score of >4 increased the likelihood ratio of difficult intubation by 7.62 times.Conclusion: A difficult airway assessment score of >4 was associated with difficult intubation.

scholarly journals Is there an optimal place to hold the endotracheal tube during direct laryngoscopy? Protocol for a Randomised Controlled Trial

2021 ◽  
Author(s):  
Manisha Sahoo ◽  
Swagata Tripathy ◽  
Nitasha Mishra
Keyword(s):  
Endotracheal Tube ◽  
Endotracheal Intubation ◽  
Controlled Trial ◽  
Scientific Evidence ◽  
Intubation Difficulty ◽  
The Mean ◽  
Randomised Controlled ◽  
Difficulty Score ◽  
Clinical Trials Registry ◽  
Rate Of Success

Abstract Background: Laryngoscopic endotracheal intubation (LEI) is a widely performed lifesaving technique. There are evidence and guidelines to help decide the optimal sized endotracheal tube (ET), laryngoscope, depth of insertion, and patient position for successful endotracheal intubation. We hypothesize that after glottic visualization, the point at which the ET is held will affect the time, ease, and success of the technique due to a difference in visualization and torque. We aim to compare two sites of holding the ET after optimal laryngeal-inlet visualization: time to intubation, rate of success of first pass intubation, intubation difficulty and complications.Methods: Supervised intubations on ASA 1-2 patients (>18 years) posted for surgery under general anesthesia performed by anesthesia trainees (experience <18 months) will be included. Patients with an anticipated difficult airway or unanticipated difficulty - CL grade > three or requiring the use of airway adjuncts will be excluded. A computer-generated numbers list will randomize patients; allocation concealed with opaque sealed envelopes. ET marked at the selected site will be handed to the intubator by the theatre-technician once she/he confirms the optimum laryngoscopic view. The entire procedure will be video recorded. Two blinded assessors will independently review the videos to document the time to intubation (TTI defined as the time from holding the ET to the removal of laryngoscope from the mouth after successful intubation) and intubation difficulty score. Postoperative sore throat and hoarseness will be recorded.Sample size: 54 experienced anesthetists were video-recorded during intubating. The site of holding ET and TTI were analyzed. The mean site was 3 SD 2.5 cm from the tip, yielding two sites for the study- 19 cm (Gr 1) and 24 cm (Gr 2). To detect a 20% difference in intubation time between groups, the confidence of 95%, and power 85%, we will need 298 patients: 180 per group after accounting for data loss.Discussion: This will be the first study to assess whether holding the tube at a particular site has any impact on the ease and time taken for intubation. This study's findings will provide the first scientific evidence for an appropriate place for holding the ET during LEI, which we feel will help trainees improve their LEI technique.Trial registration: CTRI/2019/09/021201, Clinical Trials Registry India. http://ctri.nic.in/Clinicaltrials/advsearch.php. Registered 12th September 2019,

scholarly journals SPIDS – simplified predictive intubation difficulty score

2020 ◽  
Vol 70 (6) ◽  
pp. 569
Author(s):  
Vinícius Caldeira Quintão ◽  
Cláudia Marquez Simões ◽  
Maria José Carvalho Carmona
Keyword(s):  
Intubation Difficulty ◽  
Difficulty Score

Airway assessment and management

2016 ◽  
Author(s):  
Jules Cranshaw ◽  
Tim Cook
Keyword(s):  
Difficult Airway ◽  
Difficult Intubation ◽  
Fibreoptic Intubation ◽  
Rapid Sequence Induction ◽  
Failed Intubation ◽  
Inhalational Induction ◽  
Airway Assessment ◽  
Rapid Sequence ◽  
Sequence Induction

This chapter discusses the assessment and management of the airway. It begins with methods of assessing the airway and describes the approach to the unanticipated difficult airway. Topics covered include failed intubation, techniques for managing the anticipated difficult intubation, the cannot-intubate-cannot-ventilate scenario, the management of the obstructed airway, rapid sequence induction, inhalational induction, and awake fibreoptic intubation. It concludes with a discussion of extubating the patient after a difficult intubation.

Advanced airway management

2019 ◽  
pp. 153-176
Author(s):  
Richard Craig
Keyword(s):  
Airway Management ◽  
Difficult Airway ◽  
Video Laryngoscope ◽  
Flexible Bronchoscope ◽  
Airway Assessment ◽  
Advanced Airway ◽  
Induction Of Anaesthesia ◽  
Structured Approach

Management of the difficult paediatric airway is described in this chapter. Airway assessment and a structured approach to planning for the anticipated difficult airway are the essence of the chapter. This includes a plan for induction of anaesthesia, a plan for laryngoscopy and intubation, and a plan for safe extubation. Detailed, step-by-step guides describing the techniques for intubation using a flexible bronchoscope, Macintosh-style video laryngoscope, and rigid optical stylet are provided. The conditions commonly associated with the difficult paediatric airway are classified according to the mechanism by which they cause difficulty.

Determination of the changes in the hypoglossal nerve function after suspension laryngoscopy with needle electromyography of the tongue

2004 ◽  
Vol 118 (4) ◽  
pp. 289-293 ◽  
Author(s):  
Ugur Cinar ◽  
Gokhan Akgul ◽  
Huseyin Seven ◽  
Munevver Celik ◽  
Surhan Cinar ◽  
...  
Keyword(s):  
Predictive Factors ◽  
Hypoglossal Nerve ◽  
Nerve Function ◽  
Intubation Difficulty ◽  
Needle Electromyography ◽  
Airway Assessment ◽  
Significant Difference ◽  
Difficulty Scale ◽  
Suspension Laryngoscopy

The purpose of this study was to determine changes in the hypoglossal nerve function after suspension laryngoscopy with needle electromyography of the tongue. This study also attempted to determine the possible relationship between the predictive factors of intubation difficulty by using the intubation difficulty scale, which was introduced by Adnet et al., duration of suspension laryngoscopy and changes in hypoglossal nerve function after suspension laryngoscopy. The study was performed on 39 patients who underwent suspension laryngoscopy for benign glottic pathology. Pre-operative airway assessment was evaluated by the intubation difficulty scale and the duration of suspension laryngoscopy was recorded. Needle electromyography of the tongue was performed three or four weeks after the suspension laryngoscopy. After needle electromyography of the tongue, increased polyphasia was found in 13 patients (33 per cent), bilaterally in three of them. The interference pattern was reduced in two of these 13 patients. There was no statistically significant difference in predictive factors of intubation difficulty and the duration of the operation between these 13 patients with increased polyphasiaand the remaining 26 patients with completely normal electromyography findings. These findings show that, in spite of normal clinical tongue function, subclinical changes can be detected by needle electromyography of the tongue after suspension laryngoscopy.

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