Difficult airway management in an emergency in Nepal

  • Sunil Kumar Das Patan Academy of Health Sciences, Lalitpur, Nepal
  • Gaurav Mahato Kalaiya Hospital, Kalaiya, Bara, Nepal
Keywords: Management, Difficult Airway, Emergency, Failed Intubation, Nepal


Introduction: Health care provider often face challenges in managing airway in-patients in emergency department having respiratory compromise. Here in this review, we have discussed advances in management of difficult airway in emergency setting in Nepal.

Method: Articles available in google scholar with key word “airway management,’’ “difficult airway,” “emergency,” “failed intubation,” “Nepal” were retrieved. Amongst which 14 articles were retrieved for the discussion.

Result: MMT was better for predicting difficult laryngoscopy when compared to measurement of sternomental, thyromental and inter-incisor distances and grading of mandibular protrusion. Similarly, when comparing upper lip bite test to MMT, ULBT has better sensitivity and specificity. Laryngoscopic view with 5 cm of head elevation had a better visualization.

Conclusion: The available evidence recommends using upper lip bite test in emergency setting with comparison to modified / mallampati classification. Different tests can be used in accordance to urgency of intervention.  Similarly, head elevation of 5 cm can be routinely practiced for better visualization during laryngoscopy.

Author Biographies

Sunil Kumar Das, Patan Academy of Health Sciences, Lalitpur, Nepal

GPEM Resident, Department of General Practice and Emergency Medicine, Patan Hospital

Gaurav Mahato, Kalaiya Hospital, Kalaiya, Bara, Nepal


Review Article