.

2. UPPER AIRWAY
• NASAL CAVITY
• ORAL CAVITY
• PHARYNX

3. LOWER AIRWAY
• TRCHEA
• BRONCHI
• ALVEOLI
• LUNG PARENCHYMA
• PLURA
•

4. AIRWAY OBSTRUCTION
• Obstruction of the Airway is a Medical Emergency.
• It may be partial or complete and may occur at any level of the Respiratory tract.
• If untreated Airway obstruction leads to a Lowered Blood Oxygen tension and Risk
Hypoxic Damage to the Brain, Kidneys and Heart or Even Death.

5. CAUSES OF AIRWAY OBSTRUCTION
• Decreased Muscle Tone
• Blood
• Regurgitation of Stomach Contents
• Trauma’
• Foreign Bodies
• Edema
• Inflammation
• Excessive Bronchial Secretitions
• Mucosal Edema
• Broncho Spasm
• Aspiration of Gastric Contents

6. MANUAL AIRWAY MANEUVERS

7. AIRWAY MANAGEMENT IN OPERATION
THEATRE
• Pre-Anesthetic Airway Assessment
• Preparation & Equipment Test
• Patient Positioning
• Pre-Oxygenation
• Bag & Mask Ventilation
• Intubation or Placement of a Laryngeal Mask Airway
• Confirmation of Proper Tube or Airway Placement
• Extubation

8. AIRWAY ASSESSMENT
• Mouth Opening:
An incisor distance of 3 cm or greater is desirable.
• Malampati Classification:
• Thyromental Distance:
Distance between the Chin and Superior Thyroid Notch > 3 Finger Breadth is desirable.
• Neck Cirumference:
Greater the 17” = Difficult Intubation.

9. EQUIPMENT
• An Oxygen Source
• Bag & Mask
• Laryngoscopes
• ETTs with available Stylets & Bougies
• Other Airway Devices (Oral, Nasal & Supra Glottic Airways)
• Suction
• Pulse Oximeter and CO2 Detection
• Stethoscope
• Tape
• BP and ECG Monitors
• Flexible Fiber Optic Bronchoscope-When Difficult Intubation is Anticipated

10. POSITIONING
• SNIFFING POSITION
• Patients with Morbid Obesity should be positioned on a 30 Degree Upward Ramp

11. BAG & MASK VENTILATIONS
Effective Mask Ventilation Requires:
• Tight Mask Fit
• Patent Airway
1. ONE HANDED MASK VENTILATION
2. TWO HANDED MASK VENTILATION

12. SUPRAGLOTTIC AIRWAY DEVICES
• Laryngeal Mask Airway (LMA)
• Esophageal-Tracheal Combi Tube
• King Laryngeal Tube

13. LMA

14. ADVANTAGES/DISADVANTAGES OF LMA

15. ENDOTRACHEAL INTUBATION
• Hyper Ventilate the patient
• Prepare Equipment
• Apply Sellick’s Maneuver (Cricoid Pressure) & Insert Laryngoscope
• Visualize Larynx & Insert ETT
• Glottis Visualized through Laryngoscopy
• Inflate CUFF, Ventilate & Auscultate
• Confirm Placement with an ETCO2 Detector
• Secure Tube
• Reconfirm ETT Placement

16. ETT

18. EXTUBATION
When the patient is Deeply Anesthetized or awake, the patient’s Pharynx should be
thoroughly suctioned before Extubation to decrease the potential for Aspiration of
blood & secretions.
The ETT is Untaped and CUFF is Deflated and the Tube is withdrawn in a single
smooth motion and a Face Mask is applied to deliver Oxygen.