Predicting Difficult Intubation with Indirect Laryngoscopy

Yamamoto, Ken; Tsubokawa, Tsunehisa; Sato, Keizo; Ohmura, Shigeo; Nitta, Shunichi; Kobayashi, Tsutomu

doi:10.1097/00000542-199702000-00007

Cited by 100 publications

(44 citation statements)

References 8 publications

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“…Jaw protrusion 17±26% 95±96% 5±21% C & L 3±4 or bougie required [8] 29% 85% 9% [10] Indirect laryngoscopy 69% 98% 31% C & L 3±4…”

Section: Derivation Studies* Referencementioning

confidence: 99%

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Predicting difficult intubation – worthwhile exercise or pointless ritual?

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2002

Anaesthesia

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“…Jaw protrusion 17±26% 95±96% 5±21% C & L 3±4 or bougie required [8] 29% 85% 9% [10] Indirect laryngoscopy 69% 98% 31% C & L 3±4…”

Section: Derivation Studies* Referencementioning

confidence: 99%

“…has very low sensitivity) [2]. Second, a test may perform reasonably well but be of little practical use; thus Yanamoto et al described pre-operative indirect laryngoscopy as a method of predicting dif®cult intubation with a positive predictive value of 31%, but 15% of patients were unable to tolerate the procedure [10].…”

Section: Derivation Studies* Referencementioning

confidence: 99%

Predicting difficult intubation – worthwhile exercise or pointless ritual?

Sm¹

2002

Anaesthesia

239

164

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“…In particular the decision to proceed with general anesthesia when the possibility of difficult laryngoscopy was predicted is open to debate. However a class III Mallampati view has been reported to have a positive predictive value of difficult intubation as low as 2% 27 and UK and Canadian management of these cases might differ. Importantly, the aim of our report is to consider the role of the PLMA as a rescue device after failed RSI rather than to discuss the relative merits of RSI or awake fibreoptic intubation.…”

Section: Case #2mentioning

confidence: 97%

The Proseal™ LMA is a useful rescue device during failed rapid sequence intubation: two additional cases

et al. 2005

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P Pu ur rp po os se e: : We report two cases where the ProSeal™ laryngeal mask airway (PLMA) was successfully used as a rescue device, after failed tracheal intubation, during rapid sequence induction.C Cl li in ni ic ca al l f fi in nd di in ng gs s: : The first case involved a 31-yr-old primigravida presenting for emergency Cesarean section for severe fetal distress. She had a grade 3 larynx and airway edema was observed during laryngoscopy. Attempts with a McCoy blade and gum elastic bougie failed to secure the airway. A size 4 PLMA was inserted with good airway control and surgery proceeded uneventfully. The second case involved a 51-yr-old man presenting for appendectomy. Following failed attempts at intubation, a size 5 PLMA was succesful in securing his airway and surgery proceeded uneventfully.C Co on nc cl lu us si io on ns s: : The correctly placed PLMA has potential advantages over the cLMA for airway rescue in the circumstance of failed emergency intubation in a patient with a potentially full stomach. In the two cases reported, the PLMA provided effective rescue of the airway.Objectif : Présenter deux cas où le masque laryngé ProSeal™ (MLP) a servi d'instrument de secours après l'échec de l'intubation endotrachéale pendant une induction à séquence rapide.

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“…Zahlreiche Prädiktoren, Kombinationen von Prädiktoren und auch Algorithmen sind entwickelt worden [1, 42,66,82,87,114], um die Vorhersagbarkeit für eine schwierige Intubation zu bestimmen. Bei deren Beurteilung ist es wichtig, einzelne Begriffe klar auseinander zu halten.…”

Section: Prädiktoren Für Den Schwierigen Luftwegunclassified

Vergleich von Algorithmen f�r das Management des schwierigen Atemweges

2003

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Management of the difficult airway and maintenance of the oxygenation are the most important tasks of the anaesthetist. Respiratory problems are still the most important single cause for anaesthesia-related accidents with poor outcome. Algorithms are step-wise procedures developed from a great number of recommendations and are well suited to automation and training procedures. There is strong agreement among consultants that specific strategies lead to improved outcome, although, strictly speaking the degree of benefit on airway management cannot be clearly determined. Several anaesthesia societies, including the American Society of Anesthesiology,have developed their own algorithms for management of the difficult airway. The comparison of published algorithms shows that the management of the anticipated difficult airway has to be performed in the awake patient and fiberoptic intubation is a crucial part of that procedure. There are different techniques (different blades, guide wire, laryngeal mask, fiber optics) for the management of the unanticipated difficult airway. The laryngeal mask, transtracheal access and the Combitube are recommended for the management of the cannot intubate, cannot ventilate situation. More important than the questions which algorithm, which technique and which instruments should be used,is that each department has and practices its own algorithm. This strongly depends on local circumstances and personal preferences. Daily practice is the condition for the successful use in an emergency situation. The management is easier if one uses a simple algorithm and as few instruments as possible.

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Predicting Difficult Intubation with Indirect Laryngoscopy

Abstract: Although in 15% of patients indirect laryngoscopy could not be performed because of excessive gag reflex, indirect laryngoscopy can serve as an effective method to predict difficult intubation.

Cited by 100 publications

References 8 publications

Predicting difficult intubation – worthwhile exercise or pointless ritual?

Predicting difficult intubation – worthwhile exercise or pointless ritual?

The Proseal™ LMA is a useful rescue device during failed rapid sequence intubation: two additional cases

Vergleich von Algorithmen f�r das Management des schwierigen Atemweges

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