airway emergency."
This highlights the impor-
tance of planning for crisis sit-
uations, even for patients that
present no red flags (like an
overbite, short neck or high
BMI) during a pre-anesthesia
exam. Keep difficult airway
equipment readily on hand in
"standardized equipment
carts, so that they're all the
same and everyone knows
what's in them," says anesthe-
siologist Paul Patane, MD,
MBA, CPE, with Ballas
Anesthesia in Creve Coeur,
Mo. "The trouble comes when
you keep the bronchoscope in
closet 4 because you don't
want to buy the right size cart
to fit it in."
2. There's more than one way to assess. Because this is the
way they were trained, many anesthesia providers depend entirely on a
patient's Mallampati classification for predicting the ease of intubation.
Incorporate other methods, including the upper bite lip test (which
assesses mandibular mobility), the thyromental distance (which esti-
mates mandibular space) or the 11-point airway assessment scale put
forth by Jonathan Benumof, MD, a professor of anesthesia in the
School of Medicine at the University of California, San Diego.
9 8 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • A P R I L 2 0 1 7
• TRIANGLE OF INTUBATION Getting a patient into the ideal sniffing
position before a procedure will save you from having to reposition him for
intubation should problems arise.
Pamela
Bevelhymer,
RN,
BSN
