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 - 4D - 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

4D
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