Remote Airway Imaging to Supplement Pre-anesthesia Assessment

Pre-operative physical exam is critical to safely providing anesthesia to patients. This is done in a face to face session with the patient. The patient is asked to widely open their mouth and stick their tongue out. The airway is then 'graded' according to the classification of Mallampati. Sometimes an anesthesia provider is not immediately available to make this assessment. We examined remote assessment of patient airways. Ten non-patient volunteers were studied. Each was examined in person. Each subject also separately had a close-up picture of their mouth open using a cell phone camera equipped with a built in flash. This picture was transmitted and then graded in a blinded fashion by the same experienced anesthesiologist. In eight of ten subjects, the in person scoring agreed with the cell phone flash picture scoring. Thus remote airway assessment may be helpful when providers are physically remote.