Doing my weekly reading and came across an interesting article on airway positioning.
here it is !
Age and Gender Are Important Considerations in Choosing the Sniffing Position for Laryngoscopic View
That then lead me to find this article..
Airway management and patient positioning : a clinical perspective
And finally like all things I compare for airway, I go back to a great teacher..
Ear to sternal notch positioning
Take home points :
- Sniffing position is 3 elements – lower neck flexion, upper neck extension & atlanto-occipital joint extension
- “”Win with the chin” is a more useful aide memoire to good sniffing position for airway management
- The Ramped position or Ear to Sternal notch is superior for obese patients
- a 7cm hard head rest is used in most airway studies to provide “sniffing position” conditions. Dont think a soft pillow is good enough!
- Young males <50yo are more likely to benefit from the “sniffing position” vs females or those >50yo who may benefit more from ear to sternal notch position
- Face plane parallel to ceiling or tilted with atlanto-occipital extension ( sniffing position) will be optimal depending on the patient anatomy/habitus. Maximal chin extension will afford greater mouth opening/jaw movement but may make laryngeal visualisation with DL more difficult.
- Position is everything