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Bệnh nhân ở các lớp 3 và 4 được coi là khó khăn intubate và những người trong lớp 1 và 2 được coi là intubations khả thi. Điều quan trọng là nhận ra rằng hệ thống này không phải là không thể sai lầm và bệnh nhân trong 2 lớp đôi khi không thể được đặt nội khí quản. | emedicina Evaluation of the airway It is based upon the visibility of the pharyngeal structures with the mouth open as wide as possible Figure 1.1 . Patients are classified as follows Figure 1.1 Structures seen on opening of mouth for Mallampati Grades 1-4. Grade 1 faucial pillars soft palate and uvula visible Grade 2 faucial pillars soft palate visible but uvula masked by the base of the tongue Grade 3 soft palate only visible Grade 4 soft palate not visible. Patients in Grades 3 and 4 are considered difficult to intubate and those in Grades 1 and 2 are considered feasible intubations. It is important to realise that this system is not infallible and patients in Grade 2 sometimes cannot be intubated. Wilson risk factor scoring system Table 1.1 Five anatomical features are assessed and a total risk score of 2 is said to predict 75 of difficult intubations. Thyromental distance The thyromental distance Patil test is the distance from the thyroid cartilage to the mental prominence when the neck is extended fully 5 emedicina How to Survive in Anaesthesia Table 1.1 Wilson risk factor scoring system for difficult intubation Risk factor Score Criteria Weight 0 90 kg 1 90-110 kg 2 110 kg Head and neck movement 0 90 1 about 90 2 90 Jaw movement 0 incisor gap 5 cm or subluxation 0 1 incisor gap 5 cm and subluxation 0 2 incisor gap 5 cm and subluxation 0 Receding mandible 0 normal 1 moderate 2 severe Buck teeth 0 normal 1 moderate 2 severe Figure 1.2 Line shows the thyromental distance from the thyroid cartilage to the tip of the chin. Figure 1.2 . In the absence of other anatomical factors if the distance is 6-5 cm problems should not occur with intubation. A distance of 6 cm suggests laryngoscopy will be impossible and for distances between 6-6-5 cm laryngoscopy is considered difficult 6 emedicina Evaluation of the airway but possible. This measurement may predict up to 75 of difficult intubations. Sternomental distance This test is claimed to predict up to 90 of difficult
