1. Airway 101
UCSF-Fresno
June 19, 2015

2. Objectives
Understand the LEMON Law and why it is an important predictor of airways
Practice bagging and intubation
Practice utilizing airway adjuncts
Recognize a difficult airway

3. Approach to the Airway Is this airway going to be difficult?
What tools do I need?
What is my blade of choice?
What is my backup plan?

4. Ideal conditions for intubation
Ideal Lighting, positioning, etc.
Plenty of assistance
Time to prepare, plan, discuss
Option to Abort
Empty Stomach
Back up available

5. Adult – Normal Cords

7. LEMON Law – predictor of difficult intubations
L - Look Externally: buck teeth, small jaw, external trauma
E - Evaluate Internally: 3-3-2
M - Mallampati Score: open mouth and stick out the tongue w/o saying “Aaahh”
O - Obstruction: large tongue, neck tumors, previous trach
N - Neck Mobility: chin to chest, neck range of motion

8. Look Externally – Is this going to be a difficult or easy airway?

9. Look Externally – Is this going to be a difficult or easy airway?

10. Look Externally – Are these going to be a difficult or easy airways?

11. Evaluate 3-3-2

12. Mallampati Score

13. Mallampati Class I & II

14. Mallampati Class III & IV
Uh Oh!

15. Look for OBSTRUCTION – Is this going to be a difficult or easy airway?

16. Neck Mobility – Is this going to be a difficult or easy airway?

17. Neck Mobility– Is this going to be a difficult or easy airway?

18. Can’t Intubate, Can’t Ventilate
Occurs 1:10,000 patients
BVM Failure?
You haven’t failed
with the BVM until 2
nasal airways & an
oropharyngeal
airway are in place

19. NEXT……..
Break up into 2 groups of 5 people
15 minutes at each station

20. Station 2: Bagging & Airway Adjuncts Objectives:
1. List equipment needed for BLS airway management
2. Master one and two person bagging techniques
3. Practice using airway adjuncts
4. Review intubation roll

21. Station 3: Intubation Objectives:
1. List the equipment needed for intubation
2. Describe the difference between a Mac and Miller Blade
3. Practice mechanics of intubation
4. List tools to recognize proper ETT placement