Ravi Alagar

Ed Burdett

THE AIRWAY

SpR in Anaesthesia

UCL
the centre for
Anaesthesia
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
Laryngeal mask (LMA)
• Endotracheal tubes
The secure airway is a cuffed tube in the
trachea
LMA
Sometimes it can be difficult
Thank you

Any questions?