The Difficult Airway - 2

Grades of Difficult Mask Ventilation
(Kheterpal et al, 2006)

  1. Grade 1 (77.4% incidence in 22,660 cases)
      Ventilated by mask
  2. Grade 2 (21.1%)
      Ventilated by mask with oral airway/adjuvant with or without muscle relaxant
  3. Grade 3 (1.4%)
      Difficult ventilation (inadequate, unstable, or requiring two providers) with or without muscle relaxants
  4. Grade 4 (0.16%)
      Unable to mask ventilate with or without muscle relaxant

Grades of Difficult Laryngoscopy:
(Cormack and Lehane)

Grade I: most of glottis is seen
Grade II: only posterior portion of glottis can be seen (May not be ASA Task Force "difficult" if some part of the vocal cords are seen.)
Grade III: only epiglottis may be seen (none of glottis seen)(ASA Task Force "difficult.")
Grade IV: neither epiglottis nor glottis can be seen (ASA Task Force "difficult.")




Greg Gordon MD
Updated: