RT Book, Section
A1 Wafa, Karim
A1 Bailey, Jonathan G.
A1 Hung, Orlando R.
A2 Hung, Orlando R.
A2 Murphy, Michael F.
SR Print(0)
ID 1202474570
T1 Pharmacology of Intubation
T2 Hung’s Management of the Difficult and Failed Airway, 4<sup>th</sup> Edition
YR 2024
FD 2024
PB McGraw Hill
PP New York, NY
SN 9781264278329
LK accessanesthesiology.mhmedical.com/content.aspx?aid=1202474570
RD 2024/10/14
AB A  41-year-old  female  with  acute  cholecystitis  presents  to  the  operating  room  (OR)  for  laparoscopic  cholecystectomy.  The  patient’s  medical  history  is  significant  for  type  II  diabetes,  gastroesophageal  reflux  disease,  obesity  (BMI  52  kg·m−2)  and  obstructive  sleep  apnea  (OSA)  with  no  surgical  history.  She  has  been  using  a  continuous  positive  airway  pressure  machine  regularly  for  the  past  3  years  and  her  serum  glucose  levels  have  been  well  controlled  (A1C  6.5%).  When  asked,  she  endorsed  symptoms  of  free  reflux,  waking  her  up  in  the  night  3  to  4  times  a  week.  She  is  on  pantoprazole  40  mg  PO  once  daily  and  has  no  allergies.  She  is  alert  and  in  no  distress  but  has  had  multiple  episodes  of  vomiting  in  the  past  24  hours.  Her  last  meal  was  over  24  hours  ago.  A  focused  cardiovascular  and  respiratory  exam  were  unremarkable,  and  her  vitals  were  all  within  normal  limits.  An  airway  exam  was  completed  and  showed  a  Mallampati  class  III,  good  mouth  opening  (>5  cm),  good  thyromental  distance  (6  cm),  good  mandibular  protrusion,  and  normal  neck  extension.  There  were  no  missing,  loose,  or  protruding  teeth.