Date of Award
Spring 4-28-2024
Document Type
Project
Degree Name
Doctor of Nursing Practice (DNP)
Department
Nursing
Advisor
Dr. Kacy Ballard CRNA, DNP
First Committee Member
Dr. Joy Shoemaker DNP, RN, APRN.CNP, FNP-C, CNE
Second Committee Member
Dr. Amy Bishop DNP, AGCNS
Keywords
anesthesia, airway assessment, LEMON law, difficult airway
Subject Categories
Medicine and Health Sciences
Abstract
Managing the airway is the cornerstone of anesthesia care. However, difficult airway or intubation is not clearly defined. A major complication with a difficult airway is a cannot intubate, cannot ventilate (CICV) situation, which is reported to be as high as 10%. In addition, according to the American Society of Anesthesiologists (ASA) Closed Claim Study, "Adverse respiratory events are the most common type of injury, with difficult intubation [DI] and ventilation contributing to most of the cases. Twenty-eight percent of all anesthesia deaths are related to a CICV situation. As anesthesia evolves, basic airway assessments were developed and include mallampati (MP), thyromental distance (TMD), upper lip bite test (ULBT), and interincisor distance (IID). However, not one basic airway assessment accurately predicts a DI.
The problem is inappropriate or inadequate airway management because a difficult airway can lead to an emergency, such as an anoxic brain injury, respiratory compromise, or even cardiac arrest. The DNP project aims to implement a standardized guideline for the preoperative assessment tool, the LEMON law, as the standard of care for preoperative airway assessment in patients undergoing surgical operations requiring endotracheal tube (ETT) intubation. Theoretical implementation plan at a medical center in the Midwest utilizing a direct supervision anesthesia model to enact the Plan-Do-Check-Act (PDCA) model to evaluate the effectiveness and outcomes relating to the prediction of difficult airway, the prevalence of hypoxia, and effect on patients.
Keywords: anesthesia, airway assessment, LEMON law, difficult airway
Acknowledgement 1
1
Acknowledgement 2
1
Licensing Permission
Copyright, all rights reserved. Fair Use
Recommended Citation
Kleinfelder, Morgan, "Guidelines for the Optimal Assessment of Airway to Predict Difficult Intubation" (2024). Doctor of Nursing Practice Scholarly Projects. 110.
https://digitalcommons.otterbein.edu/stu_doc/110