Professional Documents
Culture Documents
Pat Melanson, MD
The Difficult Airway
• C-spine mobility
• External dimensions ( 3-3-2 rule)
– Mouth opening 3 fingers (TMJ)
– Mandible large enough to accommodate
tongue - 3 fingers from tip of chin to hyoid
– Length of neck/position of larynx - 2 fingers
between top of thyroid and floor of jaw
Prediction of the Difficult
Airway (con’t)
• Teeth
– large or protruding incisors obstruct vision
– jagged teeth can lacerate balloon
• Oral dimensions
– narrow facial features and high arched
palates (decreased lateral space)
– Mallimpadi classification
Mallimpadi Classification
(Tongue to Pharyngeal Size)
• Inability to oxygenate
The Failed Intubation