Preoperative Physical Exam:

1. Inspect for factors indicative of difficult BVM, LMA, or Intubation. 

2. Apply the 332-1 Rule (The 1 is the Upper Lip Bite Test which should equal about one pinky finger width of forward jaw protrusion) 

3. Assign a Mallampati Score 

4. Screen for neck mobility 

5. Focused Cardio-Resp exam. Can examine patients veins too.

References:

1.  Sharma S, Patel R, Hashmi MF, Friede R. 3-3-2 Rule. In: StatPearls. StatPearls Publishing; 2020. Accessed June 8, 2020. http://www.ncbi.nlm.nih.gov/books/NBK493235/

2.  Safavi M, Honarmand A, Amoushahi M. Prediction of difficult laryngoscopy: Extended mallampati score versus the MMT, ULBT and RHTMD. Adv Biomed Res. 2014;3. doi:10.4103/2277-9175.133270

3.  Mahmoodpoor A, Soleimanpour H, Nia KS, et al. Sensitivity of Palm Print, Modified Mallampati Score and 3-3-2 Rule in Prediction of Difficult Intubation. Int J Prev Med. 2013;4(9):1063-1069.

4.  Sullivan P. Ottawa Anesthesia Primer. ECHO BOOK PUBLISHING; 2012.

5.  Butterworth J, Mackey D, Wasnick J. Morgan & Mikhail’s Clinical Anesthesiology. 5th ed. McGraw-Hill Education; 2013.

Have questions, comments, corrections, or concerns? Please reach out via email:

anesthesiaclerkship@gmail.com

All research, scriptwriting and recording was by Blake Birnie, MD 2021 candidate at UBC's Southern Medical School Program