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Anaes VivasAirway management

Anaes Vivas · Airway management

Data viva — Cormack-Lehane grade, BURP and the capnography confirmation

A data viva on the three examined artefacts of direct laryngoscopy taken together — the four Cormack-Lehane grades (the view obtained, and the grade that defines the difficult intubation), the BURP vector (backward, upward, rightward pressure on the thyroid cartilage to improve the view, distinct from cricoid pressure), and the sustained square-wave capnography trace (the definitive confirmation of tracheal placement). Covers the grade definitions, the manoeuvres that improve a poor grade, and the fatal consequence of an unrecognised oesophageal intubation.

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Prompt
A three-part figure. Panel A: four labelled diagrams of the laryngoscopic view graded Cormack-Lehane I to IV. Panel B: a thyroid-cartilage vector arrow labelled backward, upward, rightward (BURP). Panel C: a sustained square-wave capnography trace at end-tidal around 5 kPa over six breaths.

Stimulus

A three-part figure displayed for the candidate. Panel A shows four labelled laryngoscopic views graded Cormack-Lehane I to IV: grade I (most of the glottis visible), grade II (posterior glottis and arytenoid cartilages visible, anterior glottis not), grade III (epiglottis only), grade IV (neither glottis nor epiglottis, soft palate only). Panel B shows a vector arrow on the thyroid cartilage pointing backward, upward and rightward, labelled BURP. Panel C shows a sustained square-wave capnography trace at an end-tidal carbon dioxide of around 5 kPa over six breaths.[7]

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References7ShowHide
  1. [1]Black KM, et al. Anesthesia Care, Complications, and Airway Management for Spinal Muscular Atrophy. Anesth Analg, 2026.PMID 42363899
  2. [2]Ghaffar S, et al. Physiological difficult airway management in the emergency department. JPMA, 2026.PMID 42363338
  3. [3]Ipsen EO, et al. Remifentanil Versus Rocuronium for Optimising Video Laryngoscopy Assisted Tracheal Intubation. Acta Anaesthesiol Scand, 2026.PMID 42304626
  4. [4]Jiang Y, et al. Effects of electroacupuncture-assisted tubeless anesthesia versus double-lumen endotracheal tube. Medicine, 2026.PMID 42363554
  5. [5]Migliorelli S, et al. Clinical Evaluation of a Non-inflatable Visual Laryngeal Mask Airway. Cureus, 2026.PMID 42291977
  6. [6]Shionoya M, et al. Comparison of the Effects of Remimazolam and Propofol, With Epinephrine-containing Lidocaine, on Rocuronium-induced Muscle Relaxation. Anesth Prog, 2026.PMID 42307548
  7. [7]Bersten AD, Soni N (eds) Oh's Intensive Care Manual. 8th edition, Elsevier, 2018.
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