Clear lecture NAPH 4 : Predicting difficult airway TMJ, thyromental distance, neck extension, mouth opening mallampati (class

ss III : 21%) (class IV : 4.7%) AO joint extension mandibular protrusion, inter-incisor space low sensitivity, therefore use mutiple predictors limited joint mobilty syndrome - DM 1 (30-40%) - due to glycosalation difficult mask ventilation - age , bmi, snoring, lack of teeth, beard, hx RT to neck, - peter palm ? Khatarpal ? Difficult lma insertion stiff lungs, stiff neck restricted mouth opening LMA dr. archie brain 1981 no need vc visualization 1st pass success no need nmb insertion independent of predictors of difficult intubation not impeded inline inserted in non-conventional conduit for drug adminstration disadvantage gastric insufflation suboptimal position inadequate ventilation cannot generate high inflation pressure in bronchospastic patient (<20 mm Hg 1st generation vs 2nd generation airway device (british classification) improve laryngeal seal improve gastric decompression integral bite block lma classified igel cuffed perilaryngeal, preformed (termoplastic igel ) (nontermoplastic poor seal (leak beyond cheaper shaft bigger can put larger ett easier to insert as more rigid gastric drain smaller

combitube LMA - conduit for intubation: to introduce ett/fibreoptic (6.5 lma 4) (7 lma 5) only protude 8 cm beyond grille of lma - cannot intubate + ventilate : rescue device for ventilation aintree tube exchange (can remove lma , and put larger ett, can advance ett to appropriate depth adaption of cook airway exchange catheter cannot insert smaller than size 7 ett ext diameter 6.5, int diameter 4.5mm fastrach insert lma (handle bar) lube -> insert ett use stabilizer to remove lma (ensure dun shear off ett pilot balloon) specialized lma for intubation (3 devices ) ?? iora intubating excel ila 0.008% di 5.8% predictors and clinical outcomes from failed laryngeal mask airway unique

satya krishna : study of 15795 intubating laryngeal airway

video laryngoscope indirect laryngoscopy images : magnified, recorded bonfils pentax