一般常見呼吸道插管評估因素的因子分析（PPT33）课件.pptVIP

The factor analyzing on predictors of tracheal intubation一般常見呼吸道插管評估因素的因子分析 嘉義基督教醫院 麻醉科 吳玉雪 Airway Assessment and Evaluation History elements and physical examination Variable predictive methods and scores for 1. unanticipated difficult mask ventilation--- (1) “OBESE” (Langeron et al): The Obese (body mass index 26 kg/m2)/ The Bearded / The Elderly (older than 55 y)/ The Snorers / The Edentulous (2) others: mandibular protrusion test; Sleep apnea; Thick/obese neck anatomy; Mallampati classification Airway Assessment and Evaluation Variable predictive methods and scores 2. unanticipated difficult intubation--- (1) the LEMON or the MELON scale: Look externally, Evaluate the 3-3-2 rule, Mallampati, Obstruction, Neck mobility (2) the LM – MAP (Laryngeal Mask MAP) Rule : L = Look for External face Deformities; M = Mallampati; M = Measurements 3-3-2-1 OR 1-2-3-3 Fingers; A = A- O Extension (Atlanto- Occipital); P = Pathological obstructive Conditions, Edema / Glottic Trauma Airway Assessment and Evaluation (3) the 4 Ds : Dentition (prominent upper incisors, receding chin); Distortion (edema, blood, vomits, tumor, infection); Disproportion (short chin-to-larynx distance, bull neck, large tongue, small mouth); Dysmobility (TMJ and cervical spine) (4) the Wilson Risk Score: weight, head and neck movement, jaw movement, receding mandible, and buck teeth Airway Assessment and Evaluation (5) Arné model score : The Wilson Risk Score The LEMON or The MELON Scale