Prediksi Intubasi

Evaluasi Kesulitan Ventilasi

Kriteria ventilasi sulit (Langeron et al) 2 dari:

OBESE

1. Obese (BMI>26 kg/m2)

2. Bearded

3. Elderly (>55 th)

4. Snorers

5. Edentulous

Evaluasi Kesulitan Intubasi

Kriteria :

- Skala LEMON atau MELON

- LM MAP

- 4 D

- Wilson Risk Scale

- Magboul 4M

Skala LEMON atau MELON

Look externally

Evaluate 3-3-2 rule

Mallampati

Obstruction

Neck mobility

Tabel Skala LEMON

LM-MAP

Look for external face deformities

Mallampati

Measure 3-3-2-1 fingers

Atlanto-occipital extension

Pathological obstructive conditions

4 D

Dentition(prominent upper incisor, receding chin)

Distortion(edema, blood, vomits, tumor, infection)

Disproportion(short chin, bull neck, large tongue, small mouth)

Dysmobility(TMJ, cervical spine)

Wilson Risk Score

Weight (0=<90kg,1=90-110kg,2=>110kg)

Head and neck movement (0=>90°,1=90°,2=<90°)

Jaw movement (0=IG>5cm,SL>0, 1=IG<5cm,SL=0, 2=IG<5cm,SL<0)

Receding mandible (0=normal, 1=moderate, 2=severe)

Buck teeth (0=normal, 1=moderate, 2=severe)

Total max 10 points

Magboul 4 MS

Mallampati

Measurement

Movement

Malformation of STOP (Skull,Teeth,Obstruction,Pathology)

Persiapan Dasar Intubasi Sulit

- Laringoskop berbagai ukuran- ETT berbagai ukuran- Introducer (stylet, elastic bougie)- Oral dan nasal airway- Set krikotirotomi- Suction- Assistant yang terlatih- LMA berbagai ukuran