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Assessment of Difficulty

Difficult Bag Mask Ventilation

MMask Seal: normal anatomy; absence of facial hair; lack of vomitus/bleeding/sweat; facial trauma
OObstruction/Obesity. BMI > 26
AAge. >55
NNo Teeth. Use the patient's dentures when bagging and remove for intubation.
SStiffness. PTX; COPD; Asthma; ARDS; Pulm Edema; Pulm fibrosis

Difficult Supraglottic Airway Device Placement

RRestricted mouth opening.
OObstruction.
DDisrupted or distorted airway
SStiff lungs or cervical spine

Difficult Intubation

LLook. Abnormal facies? Body habitus? Unusual anatomy? Facial trauma?
EEvaluate. 3 finger breadth (patient's own) in mouth at maximal opening; 3 finger breadth between mentum and hyoid; 2 finger breadth between hyoid and thyroid notch.
MMallampati. I – full uvula; II – partial uvula; III – soft palate; IV – hard palate
OObstruction/Obesity.
NNeck Mobility. RA; ankylosing spondylitis; DM; trauma; mentomandibular line <35deg from horizontal

Difficult Cricothyrotomy

SSurgery or Scarring
MMass. Hematoma; abscess; malignancy.
AAccess. Obesity; short neck; poor landmarks
RRadiation.
TTumor.

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