Anesthesia                   Airway Management
                             =================
þ Levitan Tips
  <Levitan.TXT>

þ Sellick Manuever (cricoid pressure)
  <Sellick.TXT>
 - Deprecated in the literature
 - 20 lbs. of pressure ("press on bridge of nose until it hurts, that's about
   20 lbs. of pressure.)
 - teaching is that if patient actively vomits, release pressure and turn
   patient on side.

þ BURP Manuever
  - Backward, upward, rightward movement of larynx by assistant
  - makes it harder to intubate
    [Snider DD et al. The "BURP" maneuver worsens the glottic view when applied
    in combination with cricoid pressure. Can J Anaesth 2005 Jan; 52:100-4.]
  - However, manual movement of the larynx by the intubator, held there by
    assistant, shown to improve intubation visualization

þ LEMON preparation for RIS mnemonic from Ron Walls' National Emergency Airway
  Course:
 - L: Look for anatomic features that may make ventilation or intubation
   difficult.
  + Morbid obesity
  + Facial or neck trauma
  + Large or jagged teeth
  + Protruding tongue
  + Facial hair
  + Narrow facial features
 - E: Examine the airway "the 3-3-2" rule
  + 3 finger mouth opening
  + 3 finger mentum to hyoid
  + 2 finger floor of mouth to thyroid cartilage
 - M: Mallampati score to predict laryngeal visualization
  + with patient seated, have them extend neck, open mouth and protrude tongue
  + observe the degree of visualization of the base of tongue,
   (if supine, open and depress with tongue blade, see what you can see, due
   to position will be one score lower)
   Class I: hard palate, soft palate, uvula, fauces, pillars visible
   Class II: hard palate, soft palate, uvula, fauces visible
   Class III: hard palate, soft palate, base of uvula visible
   Class IV: hard palate only visible
 - O: Look for any airway Obstructions:
  angioedema, hematoma, dentures, epiglottitis
 - N: evaluate Neck mobility
  + C-spine regitidy (immobilization or anatomic) reduces ability to alight
  the anatomic axes
  + Inability to mobilize the neck may make intubation difficult or impossible

þ Anaesthesia (Sedation/Paralysis) for Intubation:
  <A-RSI.TXT>

þ Size of ET tube:
 - width of little fingernail
 - diameter of nares
 - 16+age / 4

þ Detecting Esophageal Intubations:
  <A-Check.TXT>

þ Surgical Airways
  <A-Surg.TXT>