Lerman J

Language: English
References: 0
Page: 294-296
PDF size: 171.69 Kb.

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Preoperative evaluation

The most important evaluation of the child’s airway is observation: generally, «what you see is what you get». Two conditions should be met in order to adequately evaluate the child’s airway. First, observe the child face on and in profile. Symmetry of the mandible/maxilla is essential, but if the mandible is receded compared with the maxilla in the profile, be prepared for a challenging laryngoscopy. If the child has a syndrome, BE CAREFUL. Some children appear normal, depending on their age (eg., arthrogryposis) but present challenges to intubate the trachea. This occurs decidedly less commonly in children than adults but it does occur. Second, have the child open the mouth fully, sticks out their tongue and move the neck in a full range of motion. If all conditions are satisfactorily met, then laryngoscopy and tracheal intubation should be straightforward. The Mallampati and Cormack Lehane scores, BMI, neck circumference and thyromental distance do not predict difficult intubations in children. Previous difficulties with tracheal intubation may suggest that tracheal intubation could be difficult, although this varies with the airway pathology.