POSITIONING
When manipulating the airway, correct
patient posi-tioning is required. Relative alignment of the oral and pharyngeal
axes is achieved by having the patient in the “sniffing” position. When
cervical spine pathol-ogy is suspected, the head must be kept in a neutral
position during all airway manipulations. In-line stabilization of the neck
must be maintained dur-ing airway management in these patients, unless
appropriate films have been reviewed and cleared by a radiologist or
neurological or spine surgeon. Patients with morbid obesity should be
positioned on a 30° upward ramp, as the functional residual
capacity (FRC) of obese patients deteriorates in the supine position, leading
to more rapid deoxygen-ation should ventilation be impaired.
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