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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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]
References7ShowHide
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- [7]Bersten AD, Soni N (eds) Oh's Intensive Care Manual. 8th edition, Elsevier, 2018.