Preoperative airway assessment

                    Overview

The assessment of the patient's airway is an integral part of the preoperative workup. Airway management problems continue to be the single most common cause of morbidity and mortality attributable to anesthesia, i.e. what is most likely to get you into trouble! The purpose of the preoperative airway assessment should therefore be to predict potential problems which might be encountered, allowing a management plan to be developed ahead of time. Also, a proper airway evaluation may alert you to a patient who should be sedated by an anesthesiologist from the beginning.

Basically, the aim is to predict and therefore plan ahead for potential problems in two areas:

1. Standard laryngoscopy/ intubation

and/ or

2. Ventilation, i.e. oxygenation

In addition to identifying relevant patient factors, preoperative airway assessment should also take into account the type of procedure planned and its impact on the type of anesthesia required. The position of the patient can also be a factor. A supine sedated patient is more likely to obstruct, than one who is on his/her side or even prone but those who are lateral or prone may prove more difficult to access the airway and perform necessary maneuvers.

Like any kind of patient assessment it can be divided into history and examination, supported by clinical tests.