Basic Science and Pathophysiology

An individual’s airway may be rendered ‘difficult’ by:

• Poor Preparation

  Poor preparation may include:

  • Inadequate positioning
  • Poor availability of equipment
  • Lack of suitable personnel
  • Inadequate training
• Normal anatomical and physiological variation

  Normal anatomical and physiological variation may include:

  • Facial hair
  • Shape of jaw
  • Abnormal teeth or lack of teeth
  • Limited mouth opening
  • Size of tongue
  • Length and mobility of neck
  • Position of larynx
  • Pregnancy
• Pathological anatomical variation

  Pathological anatomical variation may include:

  • Soft tissue swelling as a result of burns, allergy/angio-oedema, infection and haematoma
  • Maxillofacial trauma
  • Cervical spine deformity or immobility, for example ankylosing spondylitis
  • Obesity
  • Abdominal distension

• Neck immobilisation

  Neck immobilisation: as in trauma, where you are unable to position the patient with head extended and neck flexed. This makes visualisation of the vocal cords harder [5].

• Foreign body obstruction