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Airway Assessment and AFOI (BMV (Predictors MOANS (Age >55, Snoring or…

- - - - Grade 4 = 0.07-1.4% (0.1-1%??)
        Neck radiation changes
        Male gender
        OSA
        MP III or IV
        Beard
        25% were difficult to intubate too
  - - - Any 2 predicts difficult with sensitivity of 72% and specificity of 76% and likelihood ratio of 2.5
- - - - 2.5cm required for LMA
      - Test: 4cm for LMA
        5cm for intubation
      - Intubating LMA 2cm
      - IIG 1.5cm or less (1 finger)
    - - Sensitive indicator for difficult intubation
    - - 3 scores, modified to 4
      - Poor sensitivity
        Poor specificity
        Low PPV
      - Alone it only predicts 35-50% of DI but high false positive rate
    - - 6-6.5cm direct laryngoscopy may be hard but intubation possible
      - <6cm direct laryngoscopy may be impossible or very difficult
    - - A - infront of upper teeth
        B - in line
        C - cannot get bottom inline with top
      - Grade C rare but diagnostic for DI
        Grade B poor PPV
      - Single test use
      - Upper lip bite test - wider inter user variability and difficult to understand
    - - Less than 12.5cm - high incidence of DI
      - Few studies but most useful singular test
      - Relies on next extension and head mobility
    - - Not very useful but >9cm seems easy
    - - Alone is not predictive
      - Associated with obesity and difficult BMV
    - - Less than 4cm retrospectively found in unexpected difficult airways
  - - - Sens 75-95% but poor PPV
      - 5 RFs given a score of 1-3
        Total possible score / 10
        
        weight (<90 90-110, >110kg)
        
        head movement >90, 90 or <90
        
        jaw movement (IIG >5, 5 or <5cm)
        
        Mandibular recession normal mod or severe
        
        Buck teeth absent moderate severe
      - Score >2 predicts 75% of difficulties
        Correct at identifying easy intubations
    - - Score of 0-12 (rated 0-2)
        Score >3 = VL, Score >7 = AFOI
    - - ENT and general surgery patients
        Slightly better at gen surg than ENT predictions but both good
      - More complicated scoring system
        Risk threshold >11
      - Identified DI with sens 90-94% and spec 92-96%