Obesity: airway eval
Generic Clinical Sciences
As with all patients, the airway of obese patients deserves a thorough physical exam (Mallampati score/mouth opening, cervical spine mobility, temporomandibular joint mobility, teeth [especially diseased/loose/artificial], thyromental distance). While obesity in and of itself does not imply a difficult airway (the association may be due to the high incidence of OSA in this patient population, a known risk for difficult intubation), obesity is associated with difficult mask ventilation’ and probably with post-operative respiratory complications. Furthermore, there is a strong relationship between obesity and OSA (despite the fact that most patients with OSA are not obese), and patients with obesity and OSA are definitely at increased risk for difficulty with mask ventilation as well as post-operative respiratory complications (4), thus any obese patient (if not all patients) should be screened for OSA.
- Standard Exam: Mallampati score/mouth opening, cervical spine mobility, temporomandibular joint mobility, teeth, thyromental distance
- STOP-BANG: snore; tired; observed obstructing; HTN; BMI > 35; age > 50; neck > 40 cm; male
- Previous Intubations: review history