(Originally presented by Dr Justin Fong)

  • Predicting difficult mask-ventilation is hard
    • 94% of difficult mask-ventilation is unanticipated 
  • Previous difficult mask-ventilation can predict future difficulty 
    • “People don’t die from a lack of intubation, they die from a lack of ventilation”
  • No classification system to date has been widely adopted in routine clinical use
    • Descriptions are limited to subjective statements
    • “easy” or “hard – with guedel”
  • Capnography is the gold-standard for identifying ventilation 
    • ANZCA requirement for every GA
    • Available for every sedated patient  
  • “Best capnography trace achieved”
    • Proposed as an objective measure to communicate difficulty
    • Equivalent to Cormack-Lehane scale for laryngoscopy

Links:

Objective description of mask ventilation. BJA 2016. K. S. Lim and J. R. Nielsen, Concord Hospital, Australia

ANZCA Guidelines on Monitoring (page 3)