Mallampatti
Class I; all visible; hard palate, soft palate, pillars, fauces, uvula
Class II; uvula partially obscured
Class III; base of uvula only
Class IV; only hard palate visible
Interincisor gap
<3cm abnormal
Jaw protrusion
Class A; able to protrude lower incisors anterior to upper incisors
Class B; lower incisors reach margin of upper incisors
Class C; lower incisors cannot protrude to the upper incisors
Thyromental distance
Distance from the tip of the thyroid cartilage to the tip of the mandible with full neck extension and mouth closed
<6.5cm predictive of increased risk
Has been modified to include ratio of TMD to body height, or as thyromenta
Neck extension
Tip of mandible > occipital protruberance
Incisor plane movement <20 degrees predictive of risk
Cormack Lehane
Grade 1; most of the glottis is visible
Grade 2; only the posterior extremity of the glottis is visible
Grade 2a; when the posterior cords are visible
Grade 2b; when only the base of the arytenoids are visible
Grade 3; only the epiglottis is visible, no part of the glottis visible
Grade 3a; when the epiglottis can be lifted from the posterior pharyngeal wall
Grade 3b; when it cannot be lifted (bougie introducer not useful)
Grade 4; not even the epiglottis can be seen
Anaphylaxis severity
Grade I; generalised cutaneous signs
Grade II; moderate multiorgan involvement
Grade III; severe multiorgan involvement
Grade IV; cardiorespiratory arrest
Grade V; death
Haemorrhagic shock class
Class I; <15%, <750ml, PR <100, normotensive, RR 14-20, UO >30, slightly anxious
Class II; 15-30%, 750-1500ml, PR 100-120, normotensive, RR 20-30, UO 20-30, mildly anxious
Class III; 30-40%, 1500-2000ml, PR 120-140, hypotensive, RR 30-40, UO 5-15, anxious/confused
Class IV; >40%, >2000ml, PR >140, hypotensive, RR >35, UO negligible, confused/lethargic
Paediatric dehydration scale
Mild; <4%, no clinical signs, increased thirst
Moderate; 4-7%, delayed CRT, increased RR, decreased turgor
Severe; ≥7%, very delayed CRT, mottled skin, signs of shock (tachycardia, hypotension, consciousness), deep acidotic breathing, decreased turgor
Awareness, Modified Brice questionnaire
What was the last thing you remember before going to sleep?
What is the first thing you remember after waking up?
Do you remember anything between going to sleep and waking up?
Did you dream during your procedure?
What was the worst thing about your operation?
ARDS severity
PaO2/FiO2 ratio
Mild; 200-300
Moderate; 100-200
Severe; <100
MET score
Poor, <4 MET; ADLs, walk indoors, light housework
Intermediate, 4-7 MET; 1 flight of stairs, walk up a hill, walk 1-2 blocks on level ground, moderate housework, garden work, sex, low energy sports
Good, >7 MET; heavy housework, running, high energy sports
Duke Activity Status index
Self-reported questionnaire of 12 activities, DASI score = sum (0-58.2)
VO2 max = 0.43 x DASI + 9.6, MET score = VO2 max / 3.5
Threshold; >34 (7 METs)
Higher risk; <25
6MWT
Distance walked on flat ground at normal pace for 6min
Median 500-600m in healthy patients
<300m correlates to ~14ml/kg/min (4 MET), poor perioperative prognosis
MMRC dyspnoea score
0; no limitation with ordinary activities
1; mild limitation, only when hurrying/uphill
2; moderate limitation, breaks when walking, slower than people of same age
3; severe limitation, breaks after 100m or a few minutes
4; very severe, cannot leave house or breathless with ADLs
COPD severity
All; FEV1/FVC <0.7
Mild; FEV1 >80% predicted
Moderate; FEV1 50-80% predicted
Severe; FEV1 30-50% predicted
Very severe; FEV1 <30% predicted
Restrictive lung disease severity
Mild; FVC or TLC 70-80% predicted
Moderate; FVC or TLC 60-70% predicted
Severe; FVC or TLC 35-60% predicted
Very severe; FVC or TLC <35% predicted
DLCO severity
Normal; 75-140% predicted
Mild; 60-75% predicted
Moderate; 40-60% predicted
Severe; <40% predicted
BODE index
Predicts COPD mortality
BMI ≤21
Obstructive lung disease; FEV1 ≤65
Dyspnoea scale score; MMRC
Exercise; 6MWT
STOPBANG
Score ≥3 indicates higher likelihood of OSA
Snores (1)
Tiredness; daytime somnolence (1)
Observed apnoeas (1)
Pressure; hypertension (1)
BMI >35 (1)
Age >50 (1)
Neck size; circumference >40cm (1)
Gender; male (1)
Sleep apnoea severity, AHI/RDI
Mild; 5-15/hour
Moderate; 15-30/hour
Severe; >30/hour
EuroSCORE
Patient related factors; age, sex, pulmonary/vascular/neurological/renal disease, endocarditis, previous cardiac surgery, critical preoperative state
Cardiac related factors; angina, LV dysfunction, infarction, pulmonary hypertension
Operation related factors; emergency, additional procedure planned, thoracic aortic surgery
Revised Cardiac Risk Index
Ischaemic heart disease (1)
Cardiac failure (1)
Cerebrovascular disease (1)
Insulin therapy (1)
Creatinine >180umol/ml (1)
High risk surgery – intra-thoracic, intra-abdominal, supra-inguinal vascular (1)
NYHA heart failure scale
I; no symptoms/limitation with ordinary physical activity
II; mild symptoms/limitation during ordinary activity
III; marked symptoms/limitation during less-than-ordinary activity
IV; symptoms even at rest
