TY - CHAP M1 - Book, Section TI - Airway Management for a Patient with Upper Gastrointestinal Bleeding and an Anticipated Difficult Airway A1 - Murray, Nate A1 - Aziz, Michael A2 - Hung, Orlando R. A2 - Murphy, Michael F. PY - 2024 T2 - Hung’s Management of the Difficult and Failed Airway, 4th Edition AB - A 46-year-old man with a history of nonalcoholic steatohepatitis (NASH) cirrhosis and prior upper gastrointestinal (GI) bleeding presents to the emergency department (ED) with acute onset of hematemesis and melena. His past medical history is significant for obesity with a body mass index of 38 kg·m−2, obstructive sleep apnea (OSA) for which he declined the use of noninvasive ventilation, diabetes mellitus, and hypertension. He was noted to have ascitic fluid on his most recent liver ultrasound but has never needed large-volume paracentesis. His vital signs demonstrate a sinus tachycardia with a rate of 108 beats per minute and blood pressure of 110/68. He is afebrile and has a mildly delayed peripheral capillary refill. On exam he is an obese man, appears as stated age, in mild distress, and somewhat drowsy. He has a thick neck with palpable, but not visible, laryngeal structures. He has mild retrognathia with a decreased thyromental distance. Examination of his mouth revealed intact dentition, Mallampati IV, and inability to bring the lower incisors above the upper vermillion border. SN - PB - McGraw Hill CY - New York, NY Y2 - 2024/10/07 UR - accessanesthesiology.mhmedical.com/content.aspx?aid=1202477882 ER -