3-3-2 Rule

Overview

4.6 out of 5 (223 Reviews)

Credits

1.00

Post Assessment Questions

5

Start Date

1 Sep 2023

Last Review Date

1 Sep 2023

Expiration Date

31 Aug 2026

Estimated Time To Finish

60 Minutes


 
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Activity Description

The procedure of endotracheal intubation plays an important role in maintaining a patient's airway in various clinical scenarios, such as surgeries and critical care. However, this process can be challenging in certain patients due to anatomical variations, commonly referred to as 'difficult airways.' Clinicians can utilize the 3-3-2 rule as a predictive tool to identify and prepare for these challenging scenarios in advance to minimize complications. The 3-3-2 rule involves measuring 3 different distances in the patient's neck using the clinician's fingers. These measurements aid in predicting the ease or difficulty of intubation. Additional tools such as the LEMON scale and the Mallampati scoring system also play a valuable role in the evaluation of the airway. This activity provides an overview of the procedures and techniques involved in endotracheal intubation, with a particular emphasis on the application of the 3-3-2 rule. It also highlights the role of the interprofessional team in efficiently managing patients who require intubation.


Target Audience

This activity has been designed to meet the educational needs of physicians, physician associates, nurses, pharmacists, and nurse practitioners.

Learning Objectives

At the conclusion of this activity, the learner will be better able to:

  • Screen patients with difficult airways using the 3-3-2 rule to promptly recognize individuals who may require special consideration and preparation for airway management.
  • Differentiate airway classes using the Mallampati scoring system to assess the visibility of specific anatomical structures during a mouth-wide-open examination.
  • Evaluate for airway obstruction as part of the LEMON scale to stratify patients based on their risk of difficult airway.
  • Collaborate with anesthesiologists, surgeons, and other relevant healthcare professionals to develop comprehensive airway management plans based on the results of the 3-3-2 rule assessment.

Disclosures

StatPearls, LLC requires everyone who influences the content of an educational activity to disclose relevant financial relationships with ineligible companies that have occurred within the past 24 months. Ineligible companies are organizations whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients. All relevant conflict(s) of interest have been mitigated. Hover over contributor names for financial disclosures. Others involved in planning this educational activity have no relevant financial relationships to disclose.

Commercial Support: This activity has received NO commercial support.

Continuing Education Accreditation Information

In support of improving patient care, StatPearls, LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.

 

Physicians and Physician Associates: StatPearls, LLC designates this enduring material for a maximum of 1.00 AMA PRA Category 1 Credit(s)TM. Physicians and PAs should only claim credit commensurate with the extent of their participation in the activity.

American Board of Anesthesiology: This activity contributes to the CME component of the American Board of Anesthesiology’s redesigned Maintenance of Certification in AnesthesiologyTM (MOCA®) program, known as MOCA 2.0®. Please consult the ABA website, www.theABA.org, for a list of all MOCA 2.0 requirements.

American Board of Internal Medicine: Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.00 MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

American Board of Otolaryngology–Head and Neck Surgery: Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn their required annual part II self-assessment credit in the American Board of Otolaryngology–Head and Neck Surgery’s Continuing Certification program (formerly known as MOC). It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of recognizing participation.

American Board of Pediatrics: Successful completion of this CME activity, which includes participation in the evaluation component, enables the learner to earn up to 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit learner completion information to ACCME for the purpose of granting ABP MOC credit.

American Board of Surgery: Successful completion of this CME activity, which includes participation in the evaluation component, enables the learner to earn credit toward the CME and Self-Assessment requirement(s) of the American Board of Surgery’s Continuous Certification program. It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting ABS credit.

Royal College of Physicians and Surgeons of Canada: Through an agreement between the Accreditation Council for Continuing Medical Education and the Royal College of Physicians and Surgeons of Canada, medical practitioners participating in the Royal College MOC Program may record completion of accredited activities registered under the ACCME’s “CME in Support of MOC” program in Section 3 of the Royal College’s MOC Program.

Please consult your professional licensing board for information on the applicability and acceptance of continuing education credit for this activity.

Method of Participation and Credit

  1. Register for the activity.    
  2. Review the target audience, learning objectives, and disclosure information.
  3. Study the educational content of the enduring material.
  4. Choose the best answer to each activity test question. To receive credit and a certificate, you must pass the test questions with a minimum score of 100%.
  5. Complete the post-activity assessment survey.

If you have concerns regarding the CE/CME system, please contact support@statpearls.com.

Disclaimer

This educational activity was planned and produced in accordance with the ACCME Standards for Integrity and Independence in Accredited Continuing Education. Faculty may discuss investigational products or off-label uses of products regulated by the FDA. Readers should verify all information before employing any therapies described in this educational activity.

The information provided for this activity is for continuing education purposes only and is not meant to substitute for the independent medical/clinical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition. The information presented does not necessarily reflect the views of StatPearls or any commercial supporters of educational activities on statpearls.com. StatPearls expressly disclaims responsibility for any adverse consequences resulting directly or indirectly from information in the course, for undetected error, or through a participant's misunderstanding of the content.

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Cancellation Policy: Please see the cancellation policy. StatPearls, LLC reserves the right to cancel any course due to unforeseen circumstances.

 

 
 

Reviews

Deborah Z. on 1/6/2021

Alvar D. on 1/27/2021

Regina B. on 2/3/2021

Darcey A. on 2/13/2021

very good review

NASAR S. on 3/9/2021

Bhupendra M. on 4/27/2021

Sandeep S. on 5/8/2021

Edward C. on 5/31/2021

Excellent topic!

Antonio R. on 1/15/2023

Donald P. on 6/17/2021

Valerie H. on 6/25/2021

Sarah B. on 6/28/2021

Mark R. on 7/27/2021

F P. on 8/21/2021

DIMITRIOS T. on 9/1/2021

Doctor G. on 9/9/2021

Susan S. on 9/11/2021

Kelli H. on 9/14/2021

Timothy R. on 9/15/2021

Michael Y. on 10/1/2021

Justin L. on 10/2/2021

Antonietta S. on 10/7/2021

Laura r. on 10/25/2021

Elaine N. on 10/28/2021

Hugo N. on 10/28/2021

Jacqueline M. on 11/9/2021

Brenda G. on 11/14/2021

ANWAR S. on 11/17/2021

quang l. on 12/11/2021

Keevil H. on 12/11/2021

Aaron B. on 12/16/2021

MICHAEL B. on 12/20/2021

Brent B. on 12/20/2021

Melisande B. on 12/22/2021

Brandon C. on 12/22/2021

Kegang H. on 12/24/2021

Rene G. on 12/28/2021

Good additions to the traditional airway exam. Thanks. One question is weird, where an anesthetist tries to intubate an adult female using 100 mcg of fentanyl. I know no anesthetist who would attempt intubation with such an inadequate dose of medication. Seems odd.

Androcles L. on 12/28/2021

Cherie T. on 12/28/2021

Engy H. on 12/31/2021

SREEDEVI Y. on 1/1/2022

Debra F. on 1/3/2022

I found STATPEARLS a good resource till now (I have read only one subtopic by now after joining) for my goals of passing USMLE with highest percentile and EPIC with high credits.

DR. SCIDDHARTHA K. on 1/4/2022

Teresa c. on 1/4/2022

Hillary C. on 1/6/2022

Carlisa M. on 1/6/2022

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Indumathi D. on 2/5/2023

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Kari B. on 5/6/2022

Carrie H. on 5/11/2022

Kunwardeep D. on 5/12/2022

Pamela A. on 5/12/2022

Gregory H. on 5/14/2022

Ejaz J. on 5/19/2022

Matthew S. on 5/31/2022

Wojciech F. on 6/8/2022

Rebecca T. on 6/11/2022

AC R. on 6/24/2022

Paul M. on 6/26/2022

Louie L. on 7/2/2022

Brittany C. on 7/25/2022

Dr Jagveer S. on 8/2/2022

Kara C. on 8/7/2022

Christina L. on 8/13/2022

KIMBERLY R. on 8/18/2022

Heather C. on 8/30/2022

Brian L. on 9/16/2022

illustrations and review of the upper lip bite test which Cochrane analysis indicates is likely the most useful should be included

Mark R. on 9/26/2022

ROBERT G. on 10/6/2022

None

Leland J. on 10/9/2022

Ivonne D. on 10/15/2022

stefany w. on 10/16/2022

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Himeshkumar P. on 10/20/2022

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JORGE M. on 10/30/2022

James S. on 11/11/2022

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mariam g. on 11/18/2022

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Neda m. on 11/20/2022

Pamela T. on 11/24/2022

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Yevgeny C. on 11/30/2022

William S. on 11/30/2022

Tanya O. on 12/4/2022

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on 12/6/2022

margaret c. on 12/14/2022

Vincent M. on 12/16/2022

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albert n. on 12/19/2022

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Debra W. on 12/31/2022

Julie B. on 1/1/2023

David V. on 1/2/2023

Natalie p. on 1/2/2023

THEODORE T. on 1/4/2023

Lance C. on 1/6/2023

Kimberly H. on 1/9/2023

matthew r. on 1/12/2023

good value

Holly R. on 1/16/2023

William S. on 1/17/2023

Angelica T. on 1/25/2023

Google10

JAMES M. on 1/28/2023

May G. on 1/31/2023

Rebekah B. on 2/11/2023

Julie E. on 2/16/2023

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larry m. on 2/25/2023

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DONG D. on 3/8/2023

Marilyn C. on 3/8/2023

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MAHMOUD A. on 3/12/2023

James M. on 3/14/2023

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Lee G. on 3/21/2023

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MENGTING D. on 4/2/2023

Daniel H. on 4/4/2023

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jamal m. on 4/8/2023

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Huntington on 4/10/2023

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mariam g. on 6/7/2023

Amber S. on 6/15/2023

Howard R. on 6/21/2023

VIJAY G. on 6/29/2023

Mary C. on 6/29/2023

Pictures/diagrams say a thousand words. Why none for this lesson?

Qefli N. on 7/4/2023

Edward K. on 7/6/2023

Steven C. on 7/10/2023

Richard C. on 8/17/2023

Ryan L. on 7/14/2023

Robert R. on 7/17/2023

David R. on 7/19/2023

Sendil K. on 7/24/2023

margaret a. on 7/25/2023

A B. on 7/26/2023

Steven C. on 7/28/2023

CECIL H. on 8/8/2023

alexandria g. on 8/10/2023

Dr K. on 8/20/2023

steve k. on 8/21/2023

Allynda H. on 8/30/2023

Anna B. on 8/31/2023

Kenneth K. on 9/9/2023

on 9/11/2023

Stop with evaluations

Timothy R. on 9/14/2023

Larry V. on 9/15/2023

Very clearly articulated article

LIDIA I. on 9/17/2023

Matthew S. on 9/22/2023

Nicholas D. on 10/3/2023

Alex R. on 10/6/2023

robert s. on 10/23/2023

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steven v. on 10/24/2023

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bogdana t. on 12/11/2023

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Bhupendra M. on 1/13/2024

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UMIDJON R. on 1/9/2024

Feargal G. on 1/16/2024

TIMOTHY G. on 1/23/2024

Mirna T. on 2/11/2024

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