Question

You are called to the casualty to assist for an intubation.
How will you do an airway assessment?

Hint:

The Mallampati classification is a simple, quick tool to assess airway difficulty. Combining it with jaw movement and neck flexibility provides a more complete evaluation.

Answer 1

Step 1: Mallampati Classification.
- Assess the patient's ability to open their mouth and the visibility of the oropharyngeal structures. The Mallampati score classifies the airway based on the visibility of the soft palate, uvula, and tonsils.
- Class I: Full visibility of the soft palate, uvula, and tonsils.
- Class II: Soft palate and uvula visible, but tonsils partially obstructed.
- Class III: Only the soft palate is visible.
- Class IV: Only the hard palate is visible, indicating a potentially difficult airway.

Step 2: Jaw Movement and Mouth Opening.
- Assess the patient's ability to open the mouth widely (more than 3 cm). Restricted mouth opening suggests potential difficulty in inserting a laryngoscope.
- Evaluate jaw protrusion (the ability to bring the lower teeth forward) and the flexibility of the temporomandibular joint, which affects laryngoscopy.

Step 3: Neck Mobility and Thyromental Distance.
- Assess the patient's neck mobility, particularly the ability to extend the neck. A rigid or fixed neck may complicate intubation.
- Measure the thyromental distance (from the thyroid cartilage to the chin). A distance of less than 6 cm suggests difficulty in intubation.

Step 4: Conclusion.
A thorough airway assessment includes the Mallampati score, jaw movement, neck mobility, and thyromental distance. This helps in anticipating difficulties during intubation.