The Difficult Airway

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Mouth Opening

No matter the sequence, ABC, CAB, XYZ"you are going to have to open and maintain a patent airway on your patient at some point.  During bag-mask-ventilation you can make the determination on whether or not the airway can be fully opened.  This begins with mouth opening.  Mouth opening determines the functioning of the temperomandibular joint.  In order to facilitate endotracheal intubation a wide mouth opening is preferred.  Mouth opening should be greater than 6cm or 3 fingerbreadths.  If the mouth opening is less than that you can predict a difficult airway and may not choose the standard laryngoscope and blade and move directly to an alternate airway device or technique.  [2, 10]

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