Pre-anaesthetic Airway Assessment

Failure to properly assess and identify possible difficulties with airway management and incorporate these findings to airway management strategies can lead to a poor clinical outcome. A thorough patient history review and physical examination, including bedside airway assessment, often reveal either congenital or acquired clinical conditions that may affect airway management. Ultrasound, radiographic studies and bedside flexible endoscopy for airway assessment are often necessary to understand the mechanism of pathophysiology of the lower airway. The advancement of technology, such as three-dimensional imaging, cone-beam computer tomography and virtual endoscopy, etc., is resulting in the emergence of potential future airway assessment tools. However, the ideal assessment tool for difficult airway management does not exist and unanticipated difficulties often occur. Using multiple tests to predict difficulty in airway management is better than any single test used in isolation. In addition, adverse human factors can significantly impact airway management. The importance of incorporating cognitive aids in our routine practice cannot be underestimated. Airway assessment forms the first part of any airway management strategy, including the use of certain medications and airway techniques. As practitioners, we must rise to the occasion and perform best clinical practice; there can no longer be a disconnect in what we know and what we do. We need to be the strong link in the chain in providing safe and quality care for our patients.