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MACOCHA score for difficult ICU intubation
MACOCHA score for difficult ICU intubation
Mallampati class III or IV
Obstructive sleep apnoea syndrome
Reduced cervical spine mobility
Limited mouth opening (<3 cm)
Coma
Severe hypoxaemia (SpO2 <80%)
Operator not an anaesthesiologist
Result0 points
Lower predicted risk of difficult intubation, though ICU intubation always warrants preparation.
- MACOCHA score
- 0 of 12
When to use
- Anticipating difficult intubation before airway management in the ICU.
Formula
Mallampati III/IV (5), OSA (2), reduced cervical mobility (1), mouth opening <3 cm (1), coma (1), severe hypoxaemia (1), non-anaesthesiologist operator (1). Range 0-12; >=3 flags difficulty.
Pearls and pitfalls
- Derived and validated specifically in critically ill (not elective operating-room) patients.
- High negative predictive value: a low score is reassuring.