Airway Assesment Of The Difficult Airway Before Manipulation
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AIRWAY ASSESMENT IN TRAUMA PATIENTS Identification of the difficult airway before manipulation is the Holy Grail of clinical management. It is the first step in preparing for patient care. Selection of airway devices, techniques, and procedures all pivot on airway evaluation (Carin, 2008). Preoperative examination of the airway is essential. Identification of patients with a potentially difficult airway before anesthesia allows time to plan an appropriate anesthetic technique. Previous anesthetic records should always be consulted. However, a past record of normal tracheal intubation is no guarantee against difficulty on subsequent occasions as airway anatomy can be altered as in trauma affecting the airway. The presence of stridor or hoarse voice is warning sign for the anesthetist. As it is impossible to identify all patients with a difficult airway during preoperative assessment, the anesthetist must be prepared to manage the unexpected difficult laryngoscopy (Alan et al,. 2001).
Historical Indicators of Airway Difficulty: The intent of obtaining an airway history is to elicit previously known factors indicating that airway management has been (and likely will be) difficult. Any patient who is awake and capable of coherent conversation should be asked about prior intubation and ventilation successes or failures. Some patients possess a Medic Alert bracelet indicating a history of difficult intubation or ventilation and this can be useful in obtunded