Dear Editor,
Mallampati classification is an important airway assessment tool that is often used. It has been used with limited discriminative power for difficult tracheal intubation. It is a simple, reproducible, and reliable pre-anesthetic airway assessment method when performed properly. Modified Mallampati classification was defined by Samsoon and Young in 1987 and they mentioned 4 grades according to the anatomical structures.[1] They modified the classification given by Mallampati et al. and used it as assessment tool of difficult intubation.[2] Samsoon classified it as Grade 1: Faucial Pillars, Uvula, Soft palate, Hard palate; Grade 2: Uvula, Soft palate, Hard palate; Grade 3: Soft palate, Hard palate; Grade 4: Hard palate only.
This classification is used in each and every patient as an effective airway assessment tool. The components of Mallampati classification are ought to know by all the undergraduate, post graduate students, technical staff, and anesthesiologists. A mnemonic device is any learning technique and it aids retention of information or retrieval (remembering) in human memory. Mnemonics helps in fact remembrance and are particularly useful when the order of things is important.[3] It is always time saving, effortless learning, and simple to remember the things.
The authors are medical school teachers and designed a mnemonic for Mallampati Grading, that is helping to all the students to remember it. It is designed as “PUSH”. With each grade, delete one alphabet and finally last will be “H” as grade 4 i.e., Hard palate only (See below and in box).
Grade 1: Faucial Pillars, Uvula, Soft palate, Hard palate: PUSH
Grade 2: Uvula, Soft palate, Hard palate: USH
Grade 3: Soft palate, Hard palate: SH
Grade 4: Hard palate only: H
For last many years, the authors are using this mnemonic in teaching all students and in all airway management forums regularly. As an observation, this mnemonic is easy to learn, reproduce and implement in day-to-day practice of airway assessment and management.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
References
- 1.Samsoon GLT, Young JRB. Difficult tracheal intubation: A retrospective study. Anaesthesia. 1987;42:487–90. doi: 10.1111/j.1365-2044.1987.tb04039.x. [DOI] [PubMed] [Google Scholar]
- 2.Mallampati SR, Gatt SP, Gugino LD, Desai SP, Waraksa B, Freiberger D, et al. A clinical sign to predict difficult tracheal intubation: A prospective study. Can Anaesth Soc J. 1985;32:429–34. doi: 10.1007/BF03011357. [DOI] [PubMed] [Google Scholar]
- 3.Soanes, Catherine; Stevenson, Angus; Hawker, Sara, eds. Concise Oxford English Dictionary (Computer Software): entry «mnemonic». (11th ed.) Oxford University Press; 2006. [Google Scholar]