MACOCHA Score for Difficult Intubation in ICU
Predicts difficult intubation in critically ill patients in the ICU. MACOCHA = Mallampati III or IV, Apnoea/OSA, reduced mobility of Cervical spine, Opening mouth, Coma, Hypoxaemia, non-Anaesthesiologist.
Score interpretation
MACOCHA ≤2 — low risk of difficult intubation (~1–8%)
→ Standard intubation technique; direct laryngoscopy or video laryngoscopy; standard preparation
MACOCHA >2 — high risk of difficult intubation (>20%)
→ Call experienced intubator (anaesthesiologist); video laryngoscopy as first choice; difficult airway trolley at bedside; standby cricothyrotomy kit; preoxygenate with HFNC
Interpretation bands for the MACOCHA Score. Apply clinical judgement and local guidance.
References
- De Jong A et al. MACOCHA score: derivation and validation of a new score predictive of difficult intubation in ICU. Am J Respir Crit Care Med. 2013;187(8):832–839.
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Curated clinical cross-links plus same-class fallbacks.
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Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.