Description

The accurate prediction of difficult intubation is notoriously difficult. The limitation of bedside tests in predicting difficult intubation has been eloquently demonstrated by Yentis. To date no single test exists which fulfils the criteria of sensitive, specific, positively predictive and practical to use in daily practice. It has been shown that the accuracy of tests can be somewhat improved by combining different tests and risk scores, such as those proposed by Wilson which take a number of factors into account have become more popular. Difficulties in intubation of patients during anaesthesia can result in serious morbidity and mortality. The incidence of difficult intubation, defined as a Cormack and Lehane grade III or IV at direct laryngoscopy is reported to be between 5.9 9.3% in routine anaesthetic practice. As difficulty in intubation does not necessarily result in failure to intubate, anticipation and preparation of the awkward airway is fundamental in airway management.