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