needed."
Recognizing red flags
There's no way to know for certain which patients will prove difficult
to intubate, but several screening tools can alert providers to airways
that are likely to pose a problem. Dr. McMurray shares a few of the
methods commonly used to identify potentially problematic intuba-
tions:
• STOP-BANG questionnaire. This eight-question tool
(osmag.net/Adr8AP) helps providers predict sleep apnea risk factors
or determine the likelihood of the airway obstructing when a patient's
reflexes are decreased after induction.
• Visual assessment. Providers determine the patient's
Mallampati classification (Class I through Class IV). The rating is
based on tongue and pharyngeal size, and visualization of the uvula or
soft palette, which helps to predict the ease of intubation.
• Physical assessment. Providers check the distance from chin to
the thyroid cartilage. If it's less than three finger breadths, intubation
could prove challenging. Providers ask patients to open their mouths
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rooms' air filtration systems completed a full cycle. Performing
intubations in separate rooms meant surgical teams could get to
work as soon as patients arrived in the OR. The system saved
significant OR time, conserved PPE and reduced the anxiety of
surgical team members, who were constantly worried about
being exposed to COVID-19.
"The system was expensive from a staffing perspective, but it
was well worth it to protect our staff and increase case efficien-
cies," says Dr. Barnett.
— Dan Cook
