Difficult airway predictors were associated with decreased use of neuromuscular blocking agents in emergency airway management: a retrospective cohort study in Thailand

Difficult airway predictors were associated with decreased use of neuromuscular blocking agents in emergency airway management: a retrospective cohort study in Thailand

Airway management, Rapid sequence induction and intubation, Emergency department, Emergency
medicine, Difficult airway

Background: It is recommended that difficult airway predictors be evaluated before emergency airway
management. However, little is known about how patients with difficult airway predictors are managed in
emergency departments. We aimed to explore the incidence, management and outcomes of patients with difficult
airway predictors in an emergency department.
Methods: We conducted a retrospective study using intubation data collected by a prospective registry in an
academic emergency department from November 2017 to October 2018. Records with complete assessment of
difficult airway predictors were included. Two categories of predictors were analyzed: predicted difficult intubation
by direct laryngoscopy and predicted difficult bag-mask ventilation. The former was evaluated based on difficult
external appearance, mouth opening and thyromental distance, Mallampati score, obstruction, and limited neck
mobility as in the mnemonic “LEMON”. The latter was evaluated based on difficult mask sealing, obstruction or
obesity, absence of teeth, advanced age and reduced pulmonary compliance as in the mnemonic “MOANS”. The
incidence, management and outcomes of patients with these difficult airway predictors were explored.

Jutamas Saoraya, Komsanti Vongkulbhisa, Norawit Kijpaisalratana, Suthaporn Lumlertgul, Khrongwong Musikatavorn and Atthasit Komindr

BMC Emergency Medicine

(2021) 21:37

Fajar Bagus W

Indonesia

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