Difficult Endotracheal Intubation—Scales and Causes

Abstract

Abstract:The aim of the study is to assess the possibility of intubation in each patient, the lyche to be difficult intubation, to find all the causes of the difficult intubation, to find and apply appropriate scales for difficult intubation, to estimate the frequency of difficult intubation. Endotracheal intubation is the basic reanimation procedure performed both in hospital and out-of-hospital settings. It is carried out whenever chest movements and spontaneous respiration are compromised. Respiratory arrest may occur for a variety of reasons (such as cardac arrest, coma of any origin, poisining) or direct damage to the airways, e.g. in various traumas (damages to the face, oropharynx, larynx, trachea, chest). The basic endotracheal intubation kit contains: laryngoscope, endotracheal tubes, connectors (tube and Ambu bag connectors), complete Ambu kit (face mask and bag), 20 mL syringe for cuff inflating, suction apparatus, stylete, and Magill forceps. In order to assess the successfulness of endotracheal intubation, it is necessary first to identify patients who need to be intubated. With the aim of identifying such patients, numerous screening tests and scales have been created to predict difficult intubation. The best known and most commonly used are the Mallampati and Wilson classifications as well as the LEMON airway assessment method. Nevertheless, difficult intubation accounts for 1% of cases. It usually occurs when manipulation of the laryngoscope blade is not possible in obese patients and patients with short neck, in congenital restricted mouth opening, limited neck movement as well as limited temporomandibular joint mobility; in cases of edema, fibrosis and lesions of the tongue, pharynx and larynx; when there are anatomical variations and congenital malformations of the oral cavity, pharynx, larynx, head, neck and chest.