Simplified Airway Risk Index

Simplified Airway Risk Index (SARI) is a medical assessment tool used to predict the difficulty of endotracheal intubation. It is a simplified version of the Airway Risk Index, which is a more complex scoring system. The SARI is often used in anesthesia and critical care medicine to assess the risk of difficult airway management.

Overview

The Simplified Airway Risk Index was developed to provide a simple, easy-to-use tool for predicting the risk of difficult intubation. It is based on five key factors: Mallampati score, thyromental distance, body mass index (BMI), age, and history of snoring. Each of these factors is assigned a score, and the total score is used to predict the likelihood of difficult intubation.

Components

Mallampati Score

The Mallampati score is a classification system used to predict the ease of endotracheal intubation. It is based on the visibility of the base of the uvula, faucial pillars, and soft palate when the patient opens their mouth and protrudes their tongue.

Thyromental Distance

The thyromental distance is the distance from the thyroid notch to the mentum (chin) with the head fully extended. A short thyromental distance is associated with difficult intubation.

Body Mass Index

The body mass index (BMI) is a measure of body fat based on height and weight. A high BMI is associated with increased risk of difficult intubation due to increased neck fat and decreased neck mobility.

Age

Older age is associated with increased risk of difficult intubation due to changes in the airway anatomy and decreased neck mobility.

History of Snoring

A history of snoring is associated with increased risk of difficult intubation due to potential airway obstruction.

Scoring

Each of the five components is assigned a score from 0 to 2, with higher scores indicating increased risk. The total score ranges from 0 to 10, with scores of 4 or higher indicating a high risk of difficult intubation.

Clinical Use

The Simplified Airway Risk Index is used in various clinical settings, including preoperative assessment, emergency department, and intensive care unit. It helps clinicians to plan for potential difficulties in airway management and to decide whether to proceed with direct laryngoscopy or to use an alternative airway management technique.