Advanced airway-management
•Download as PPT, PDF•
11 likes•2,511 views
The document discusses identifying and managing difficult airways in emergency situations. It emphasizes the importance of predicting potential airway issues based on a patient's history and physical exam findings. Specific tests and factors that can help identify a difficult airway are described. The document also stresses having alternative plans for airway management if intubation is unsuccessful, such as using different techniques, devices, or establishing a surgical airway. Being prepared to promptly implement backup plans is key to managing life-threatening cannot intubate, cannot ventilate scenarios.
Report
Share
Report
Share
Recommended
Difficults airway
This document discusses the management of difficult airways. It begins with definitions of difficult airway situations according to the American Society of Anesthesiologists. It then discusses the prevalence, causes, and basic airway evaluation including the "Lemon Law" assessment. Management plans for anticipated difficult airways including having alternative intubation techniques ("Plan B" and "C") are covered. A gallery of tools for difficult intubation including different laryngoscope blades, supraglottic airways, and fiberoptic intubation are presented. The document concludes with discussions on unexpected difficult airways, the ASA difficult airway algorithm, and emphasizes being prepared with alternative intubation methods.
Airway assessment Dr. Tushar
The document discusses airway assessment for anesthesia. It defines the upper and lower airways and provides details on relevant anatomy. Key points of airway assessment are identified including patient history, external examination focusing on dentition, head and neck mobility. Specific tests like Mallampati score, thyromental distance and range of motion are described. The document emphasizes the importance of thorough airway assessment prior to procedures to anticipate difficult intubation. Advanced assessment methods involving imaging and fiberoptics are also mentioned.
Difficult airway : Made easy
vital role
Pre-oxygenation: vital
Awake intubation: consider
Alternative airway: have ready
Senior help: call early
Cricothyrotomy: know how to do
Postpone if not urgent
Don't panic, think and act
Document: vitally important
Prepare for worst
Train and practice regularly
Jet vent 2 8.2021.
Jet ventilation is a form of mechanical ventilation that uses very high respiratory rates and small tidal volumes delivered via a jet of gas. It can be used supraglottically or subglottically for procedures involving the airway. Key indications are subglottic and tracheal stenosis. The jet ventilator provides active insufflation of gas while exhalation is passive. Gas exchange occurs via mechanisms like laminar flow and Taylor dispersion. Precautions must be taken to ensure adequate ventilation and monitoring of end-tidal CO2. Complications can include barotrauma, pneumothorax, or difficulty ventilating.
airway management
The document provides an overview of airway anatomy and management techniques. It describes the anatomy starting from the nose down to the trachea. It then discusses factors that can make the airway difficult and techniques for assessing the airway. It explains various airway management techniques including mask ventilation, use of airways, laryngoscopy, intubation, and alternative techniques like LMA and needle cricothyrotomy.
MANAGEMENT OF DIFFICULT AIRWAY
This document discusses the prevalence and management of difficult airways. It notes that difficult intubation occurs in about 1 in 2,000-3,000 routine cases, while cannot intubate cannot ventilate situations arise in about 1 in 5,000-10,000 cases. Key steps in managing a difficult airway include preparing alternate airway devices, having a plan for awake intubation versus general anesthesia, and being prepared for emergency surgical access if needed. The document provides guidance on evaluating the airway, contents for a difficult airway cart, algorithms for management, and follow up care considerations.
Difficult airway management
This document provides an overview of difficult airway management in the ICU. It discusses factors that can lead to difficult intubation in ICU patients such as remote location, unstable physiology, and patient factors. It describes different techniques for managing the difficult airway including anticipated difficult airways, unanticipated difficult airways, and cannot intubate/cannot ventilate scenarios. Equipment for difficult airways is outlined including video laryngoscopes, fiberoptic scopes, supraglottic airway devices, and surgical airway options like needle cricothyroidotomy. Pre-oxygenation techniques and adjuncts to improve laryngoscopy views are also summarized.
Airway equipment
The document discusses various types of airway equipment used in anesthesia including face masks, oral and nasopharyngeal airways, laryngoscopes, and endotracheal tubes. It describes the components, uses, sizes and types of each device. Face masks allow administration of gases without an apparatus in the mouth. Oral and nasopharyngeal airways maintain an open airway. Laryngoscopes are used to visualize the larynx for intubation or foreign body removal. Endotracheal tubes provide a conduit for gases into the trachea during anesthesia. The document provides detailed information on the features and proper use of these important airway management devices.
Recommended
Difficults airway
This document discusses the management of difficult airways. It begins with definitions of difficult airway situations according to the American Society of Anesthesiologists. It then discusses the prevalence, causes, and basic airway evaluation including the "Lemon Law" assessment. Management plans for anticipated difficult airways including having alternative intubation techniques ("Plan B" and "C") are covered. A gallery of tools for difficult intubation including different laryngoscope blades, supraglottic airways, and fiberoptic intubation are presented. The document concludes with discussions on unexpected difficult airways, the ASA difficult airway algorithm, and emphasizes being prepared with alternative intubation methods.
Airway assessment Dr. Tushar
The document discusses airway assessment for anesthesia. It defines the upper and lower airways and provides details on relevant anatomy. Key points of airway assessment are identified including patient history, external examination focusing on dentition, head and neck mobility. Specific tests like Mallampati score, thyromental distance and range of motion are described. The document emphasizes the importance of thorough airway assessment prior to procedures to anticipate difficult intubation. Advanced assessment methods involving imaging and fiberoptics are also mentioned.
Difficult airway : Made easy
vital role
Pre-oxygenation: vital
Awake intubation: consider
Alternative airway: have ready
Senior help: call early
Cricothyrotomy: know how to do
Postpone if not urgent
Don't panic, think and act
Document: vitally important
Prepare for worst
Train and practice regularly
Jet vent 2 8.2021.
Jet ventilation is a form of mechanical ventilation that uses very high respiratory rates and small tidal volumes delivered via a jet of gas. It can be used supraglottically or subglottically for procedures involving the airway. Key indications are subglottic and tracheal stenosis. The jet ventilator provides active insufflation of gas while exhalation is passive. Gas exchange occurs via mechanisms like laminar flow and Taylor dispersion. Precautions must be taken to ensure adequate ventilation and monitoring of end-tidal CO2. Complications can include barotrauma, pneumothorax, or difficulty ventilating.
airway management
The document provides an overview of airway anatomy and management techniques. It describes the anatomy starting from the nose down to the trachea. It then discusses factors that can make the airway difficult and techniques for assessing the airway. It explains various airway management techniques including mask ventilation, use of airways, laryngoscopy, intubation, and alternative techniques like LMA and needle cricothyrotomy.
MANAGEMENT OF DIFFICULT AIRWAY
This document discusses the prevalence and management of difficult airways. It notes that difficult intubation occurs in about 1 in 2,000-3,000 routine cases, while cannot intubate cannot ventilate situations arise in about 1 in 5,000-10,000 cases. Key steps in managing a difficult airway include preparing alternate airway devices, having a plan for awake intubation versus general anesthesia, and being prepared for emergency surgical access if needed. The document provides guidance on evaluating the airway, contents for a difficult airway cart, algorithms for management, and follow up care considerations.
Difficult airway management
This document provides an overview of difficult airway management in the ICU. It discusses factors that can lead to difficult intubation in ICU patients such as remote location, unstable physiology, and patient factors. It describes different techniques for managing the difficult airway including anticipated difficult airways, unanticipated difficult airways, and cannot intubate/cannot ventilate scenarios. Equipment for difficult airways is outlined including video laryngoscopes, fiberoptic scopes, supraglottic airway devices, and surgical airway options like needle cricothyroidotomy. Pre-oxygenation techniques and adjuncts to improve laryngoscopy views are also summarized.
Airway equipment
The document discusses various types of airway equipment used in anesthesia including face masks, oral and nasopharyngeal airways, laryngoscopes, and endotracheal tubes. It describes the components, uses, sizes and types of each device. Face masks allow administration of gases without an apparatus in the mouth. Oral and nasopharyngeal airways maintain an open airway. Laryngoscopes are used to visualize the larynx for intubation or foreign body removal. Endotracheal tubes provide a conduit for gases into the trachea during anesthesia. The document provides detailed information on the features and proper use of these important airway management devices.
Airway anatomy
The document discusses the anatomy and physiology of the upper airway. It describes the components of the upper airway including the nose, nasopharynx, oropharynx, laryngopharynx, and larynx. It then discusses the muscles responsible for airway patency and the consequences of loss of upper airway muscle tone. Finally, it covers causes of upper airway obstruction including functional, mechanical, and those that can occur in the peri-operative period.
Blind oral and nasal intubation
This document discusses blind oral and nasal intubation techniques. It notes that fiberoptic intubation has disadvantages and may not be available everywhere. Proper training in blind intubation techniques is important to reduce complications when advanced airway equipment is unavailable. Several blind intubation methods are described, including using a bougie, the operator's thumb, or a mouth prop to guide the endotracheal tube. Awake blind intubation requires patient preparation and sedation. Nasal intubation has specific indications and considerations. Overall the document provides guidance on performing blind intubations when direct laryngoscopy is not possible.
Rapid sequence intubation
This document provides information on rapid sequence intubation (RSI) in adults. It defines RSI as the virtually simultaneous administration of a sedative and neuromuscular blocking agent to facilitate endotracheal intubation while minimizing aspiration risk. The principles of RSI are described, including preparation, preoxygenation, pretreatment, paralysis with induction, protection/positioning, tube placement confirmation, and post-intubation management. Contraindications and advantages of RSI are also outlined.
Airway management
Dr. Mir discusses airway management, noting it requires both art and science. He emphasizes the anesthesiologist's responsibility to manage the patient's airway. The document then provides details on airway anatomy, evaluating the airway, and clinical airway management techniques. It describes tools for airway assessment including history, physical exam, special investigations like radiography and tests to evaluate anatomy. Overall, the document serves to outline important considerations for airway evaluation and management.
Difficult airway
The document discusses the management of difficult airways. It defines difficult mask ventilation and difficult laryngoscopy/intubation. It describes various tests that can be used to assess a difficult airway, such as the Mallampati test, thyromental distance, sternomental distance, and neck mobility tests. Radiographic predictors of a difficult airway are also discussed, along with causes of difficult intubation related to patient anatomy and various medical conditions.
Supraglottic Airway Device
This document discusses supraglottic airway devices. It begins by introducing supraglottic airway devices and their purpose of maintaining airway patency above the glottic opening. It then classifies supraglottic devices based on generation, sealing mechanism, number of lumens, and discusses some common devices like the LMA Classic, Unique, Flexible, and Ambu Aura. Indications, contraindications, advantages, disadvantages, proper sizing, insertion technique and signs of correct placement are outlined. Potential problems and methods to reduce aspiration are also reviewed.
Difficult airway
its combination of all latest guidellines regarding difficult airway management perticularly in critical care setting.
Airway assessment
This document discusses methods for assessing a patient's airway for difficulty with mask ventilation, laryngoscopy, intubation, and a surgical airway. It describes various physical exam findings and grading scales that can help predict challenges, such as neck circumference, mouth opening, jaw protrusion, Mallampati score, thyromental distance, and laryngoscopic view with intubation. Factors like obesity, beard, lack of teeth, older age, and snoring increase risk. Proper airway assessment is important for anesthesia planning and preparing for potential difficulty.
Advanced Airway Management 1
The document outlines an agenda and objectives for a training on EMT basic advanced airway management using the pharyngeal esophageal airway device (PEAD), also known as the Combitube. The training will include lessons on respiratory anatomy and physiology, respiratory volumes and management, assessing respiratory problems, basic airway management, suctioning, and dual-lumen airway devices. It will conclude with demonstrations and skills testing on techniques like manual airway maneuvers, ventilation, suctioning, and Combitube insertion.
Airway Management
The document provides guidance on airway management in emergency situations. It discusses assessing the need for airway control, oxygen delivery devices, signs of respiratory distress, techniques for difficult intubation like video laryngoscopy, and alternative airway devices like combitubes. Factors like patient comorbidities, anatomy, and mechanism of respiratory failure help determine the best approach. Proper planning, backup devices, and skills are important for managing challenging airways.
Airway assessment
This document discusses difficult airways and methods for assessing airway difficulty. It begins by defining difficult airway and difficult mask ventilation. It then discusses factors that can predispose patients to difficult airways, such as obesity, beard, missing teeth, snoring, and certain medical conditions.
The document outlines several tests and scoring systems that can be used to assess airway difficulty, including the Mallampatti test, thyromental distance, neck mobility, and inter-incisor distance. It provides details on how to perform and interpret these assessment tests. Finally, it discusses several scoring systems like LEMON, Wilson's criteria, and Benumof's 11 parameters that can help predict difficult laryngoscopy.
PAEDIATRIC AIRWAY
Anatomy, Physiology, Airway Assessment, Airway Management, Difficult Airway Management, Airway management in Special Cases.
Percutaneous tracheostomy by Saja ALdulaijan
Percutaneous tracheostomy is a minimally invasive procedure that can be performed at the bedside to insert a tracheostomy tube. It involves using dilators of increasing size to gradually widen the incision and insert the tracheostomy tube. The Ciaglia and Griggs techniques are two common methods that use dilators over a guidewire to perform the procedure. Percutaneous tracheostomy has advantages over open surgical tracheostomy as it does not require transferring the patient to the operating room and has lower risks of complications like infection and stenosis. Proper patient positioning, identification of anatomical landmarks, and use of bronchoscopy are important for successful placement of the tracheostomy tube.
Surgical airway techniques
- Holding tracheal tube
- Providing bronchoscopic guidance
- Ventilating patient
Operator:
- Making incision
- Inserting needle/guidewire
- Passing dilators
- Inserting tracheostomy tube
Ciaglia technique
Complications of PDT
Early
- Bleeding
- Pneumothorax
- Subcutaneous emphysema
- Tracheal injury
- Infection
- Tube displacement
Late
- Stenosis
- Granuloma
- Fistula
- Tracheomalacia
Advantages of PDT
- Shorter procedure time
- Less tissue trauma
- Lower infection rates
- Impro
Airway management
This document discusses the anatomy and physiology of the airway and provides guidance on proper airway management techniques. It describes the structures of the airway from the nose to the trachea. It emphasizes the importance of evaluating each patient's airway, having the proper equipment, and developing adequate skills to successfully manage the airway. Techniques covered include use of oral and nasal airways, laryngoscopy, endotracheal intubation, and developing a backup plan for difficult airways.
Breathing circuit's
The document discusses various paediatric breathing circuits used in anaesthesia. It describes the key components and classifications of breathing circuits. The most commonly used circuits include the Mapleson A (Magill) system, which is best for spontaneous breathing but requires high fresh gas flows. The Mapleson D and Bain circuits are efferent reservoir systems that work efficiently for controlled ventilation. The Ayre's T-piece is a simple no-valve circuit designed for paediatric use. The document provides details on the construction, functioning and advantages of these different breathing circuit designs.
Low flow Anesthesia system
Low flow anaesthesia systems aim to reuse exhaled gases and minimize fresh gas flow. John Snow recognized in 1850 that most inhaled anaesthetics are exhaled unchanged, and rebreathing exhaled gases could prolong their effects. Developments over the 20th century led to widespread use of circle absorption systems. Factors like cost and pollution concerns have renewed interest in low flow anaesthesia. It requires a well-functioning circle system, gas monitoring, and attention to factors like circuit volume and gas solubility when initiating and maintaining the desired anaesthetic concentrations with minimal fresh gas flows.
Et co2
Capnography is superior to capnometry as it provides a graphical display of expired carbon dioxide (CO2) levels over time, allowing analysis of the capnographic waveform. Measuring end-tidal CO2 (ETCO2) using capnography is the best non-invasive method to verify correct endotracheal tube placement and provides valuable information about ventilation, cardiac output, and metabolism. ETCO2 levels normally approximate arterial CO2 (PaCO2) but the correlation decreases with abnormalities that increase the ventilation-perfusion mismatch. Key features of the capnographic waveform include the baseline, rise and contour of the CO2 curve which can provide diagnostic clues about various clinical conditions.
ASA Guidelines for Management of the Difficult Airway
Practice Guidelines for Management of the Difficult Airway
An Updated Report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway
Anesthesiology 2013; 118(2):251-270
Airway assesment IN ANESTHESIA
Upper airway anatomy includes the mouth, nasal cavity, nasopharynx, oropharynx, larynx, and lower airway including the trachea and bronchi. Factors predisposing to a difficult airway include congenital deformities, infections, tumors, arthritis, and injuries. A thorough airway assessment involves history, physical exam including focused tests like Mallampatti score, thyromental distance, jaw mobility, and neck range of motion to identify potential difficulties and plan management.
airwaytoday.ppt
This document discusses strategies for managing difficult airways in emergency situations. It begins by outlining goals of predicting difficult airways, having appropriate plans, and confidence in "can't intubate, can't ventilate" situations. It then discusses factors that can help identify difficult airways through past medical history, physical exam findings like thyromental distance, and classifications like Mallampati. The document emphasizes having alternative plans for airway management if intubation fails, such as BVM ventilation, supraglottic airways, or surgical techniques. It stresses the importance of paramedics feeling prepared with multiple airway options when facing emergent difficult airway scenarios.
Airway assessment in anaesthesia
Airway assessment is important for identifying patients at risk of a difficult airway. Several tests can be used including Mallampati scoring, mouth opening, neck mobility, and thyromental distance. A difficult airway is when facemask ventilation or intubation is not possible using conventional methods. It is important to prepare for difficult airway scenarios by having proper equipment and involving senior help. Identifying difficult airway risks pre-operatively allows time for planning alternative strategies to ensure patient safety.
More Related Content
What's hot
Airway anatomy
The document discusses the anatomy and physiology of the upper airway. It describes the components of the upper airway including the nose, nasopharynx, oropharynx, laryngopharynx, and larynx. It then discusses the muscles responsible for airway patency and the consequences of loss of upper airway muscle tone. Finally, it covers causes of upper airway obstruction including functional, mechanical, and those that can occur in the peri-operative period.
Blind oral and nasal intubation
This document discusses blind oral and nasal intubation techniques. It notes that fiberoptic intubation has disadvantages and may not be available everywhere. Proper training in blind intubation techniques is important to reduce complications when advanced airway equipment is unavailable. Several blind intubation methods are described, including using a bougie, the operator's thumb, or a mouth prop to guide the endotracheal tube. Awake blind intubation requires patient preparation and sedation. Nasal intubation has specific indications and considerations. Overall the document provides guidance on performing blind intubations when direct laryngoscopy is not possible.
Rapid sequence intubation
This document provides information on rapid sequence intubation (RSI) in adults. It defines RSI as the virtually simultaneous administration of a sedative and neuromuscular blocking agent to facilitate endotracheal intubation while minimizing aspiration risk. The principles of RSI are described, including preparation, preoxygenation, pretreatment, paralysis with induction, protection/positioning, tube placement confirmation, and post-intubation management. Contraindications and advantages of RSI are also outlined.
Airway management
Dr. Mir discusses airway management, noting it requires both art and science. He emphasizes the anesthesiologist's responsibility to manage the patient's airway. The document then provides details on airway anatomy, evaluating the airway, and clinical airway management techniques. It describes tools for airway assessment including history, physical exam, special investigations like radiography and tests to evaluate anatomy. Overall, the document serves to outline important considerations for airway evaluation and management.
Difficult airway
The document discusses the management of difficult airways. It defines difficult mask ventilation and difficult laryngoscopy/intubation. It describes various tests that can be used to assess a difficult airway, such as the Mallampati test, thyromental distance, sternomental distance, and neck mobility tests. Radiographic predictors of a difficult airway are also discussed, along with causes of difficult intubation related to patient anatomy and various medical conditions.
Supraglottic Airway Device
This document discusses supraglottic airway devices. It begins by introducing supraglottic airway devices and their purpose of maintaining airway patency above the glottic opening. It then classifies supraglottic devices based on generation, sealing mechanism, number of lumens, and discusses some common devices like the LMA Classic, Unique, Flexible, and Ambu Aura. Indications, contraindications, advantages, disadvantages, proper sizing, insertion technique and signs of correct placement are outlined. Potential problems and methods to reduce aspiration are also reviewed.
Difficult airway
its combination of all latest guidellines regarding difficult airway management perticularly in critical care setting.
Airway assessment
This document discusses methods for assessing a patient's airway for difficulty with mask ventilation, laryngoscopy, intubation, and a surgical airway. It describes various physical exam findings and grading scales that can help predict challenges, such as neck circumference, mouth opening, jaw protrusion, Mallampati score, thyromental distance, and laryngoscopic view with intubation. Factors like obesity, beard, lack of teeth, older age, and snoring increase risk. Proper airway assessment is important for anesthesia planning and preparing for potential difficulty.
Advanced Airway Management 1
The document outlines an agenda and objectives for a training on EMT basic advanced airway management using the pharyngeal esophageal airway device (PEAD), also known as the Combitube. The training will include lessons on respiratory anatomy and physiology, respiratory volumes and management, assessing respiratory problems, basic airway management, suctioning, and dual-lumen airway devices. It will conclude with demonstrations and skills testing on techniques like manual airway maneuvers, ventilation, suctioning, and Combitube insertion.
Airway Management
The document provides guidance on airway management in emergency situations. It discusses assessing the need for airway control, oxygen delivery devices, signs of respiratory distress, techniques for difficult intubation like video laryngoscopy, and alternative airway devices like combitubes. Factors like patient comorbidities, anatomy, and mechanism of respiratory failure help determine the best approach. Proper planning, backup devices, and skills are important for managing challenging airways.
Airway assessment
This document discusses difficult airways and methods for assessing airway difficulty. It begins by defining difficult airway and difficult mask ventilation. It then discusses factors that can predispose patients to difficult airways, such as obesity, beard, missing teeth, snoring, and certain medical conditions.
The document outlines several tests and scoring systems that can be used to assess airway difficulty, including the Mallampatti test, thyromental distance, neck mobility, and inter-incisor distance. It provides details on how to perform and interpret these assessment tests. Finally, it discusses several scoring systems like LEMON, Wilson's criteria, and Benumof's 11 parameters that can help predict difficult laryngoscopy.
PAEDIATRIC AIRWAY
Anatomy, Physiology, Airway Assessment, Airway Management, Difficult Airway Management, Airway management in Special Cases.
Percutaneous tracheostomy by Saja ALdulaijan
Percutaneous tracheostomy is a minimally invasive procedure that can be performed at the bedside to insert a tracheostomy tube. It involves using dilators of increasing size to gradually widen the incision and insert the tracheostomy tube. The Ciaglia and Griggs techniques are two common methods that use dilators over a guidewire to perform the procedure. Percutaneous tracheostomy has advantages over open surgical tracheostomy as it does not require transferring the patient to the operating room and has lower risks of complications like infection and stenosis. Proper patient positioning, identification of anatomical landmarks, and use of bronchoscopy are important for successful placement of the tracheostomy tube.
Surgical airway techniques
- Holding tracheal tube
- Providing bronchoscopic guidance
- Ventilating patient
Operator:
- Making incision
- Inserting needle/guidewire
- Passing dilators
- Inserting tracheostomy tube
Ciaglia technique
Complications of PDT
Early
- Bleeding
- Pneumothorax
- Subcutaneous emphysema
- Tracheal injury
- Infection
- Tube displacement
Late
- Stenosis
- Granuloma
- Fistula
- Tracheomalacia
Advantages of PDT
- Shorter procedure time
- Less tissue trauma
- Lower infection rates
- Impro
Airway management
This document discusses the anatomy and physiology of the airway and provides guidance on proper airway management techniques. It describes the structures of the airway from the nose to the trachea. It emphasizes the importance of evaluating each patient's airway, having the proper equipment, and developing adequate skills to successfully manage the airway. Techniques covered include use of oral and nasal airways, laryngoscopy, endotracheal intubation, and developing a backup plan for difficult airways.
Breathing circuit's
The document discusses various paediatric breathing circuits used in anaesthesia. It describes the key components and classifications of breathing circuits. The most commonly used circuits include the Mapleson A (Magill) system, which is best for spontaneous breathing but requires high fresh gas flows. The Mapleson D and Bain circuits are efferent reservoir systems that work efficiently for controlled ventilation. The Ayre's T-piece is a simple no-valve circuit designed for paediatric use. The document provides details on the construction, functioning and advantages of these different breathing circuit designs.
Low flow Anesthesia system
Low flow anaesthesia systems aim to reuse exhaled gases and minimize fresh gas flow. John Snow recognized in 1850 that most inhaled anaesthetics are exhaled unchanged, and rebreathing exhaled gases could prolong their effects. Developments over the 20th century led to widespread use of circle absorption systems. Factors like cost and pollution concerns have renewed interest in low flow anaesthesia. It requires a well-functioning circle system, gas monitoring, and attention to factors like circuit volume and gas solubility when initiating and maintaining the desired anaesthetic concentrations with minimal fresh gas flows.
Et co2
Capnography is superior to capnometry as it provides a graphical display of expired carbon dioxide (CO2) levels over time, allowing analysis of the capnographic waveform. Measuring end-tidal CO2 (ETCO2) using capnography is the best non-invasive method to verify correct endotracheal tube placement and provides valuable information about ventilation, cardiac output, and metabolism. ETCO2 levels normally approximate arterial CO2 (PaCO2) but the correlation decreases with abnormalities that increase the ventilation-perfusion mismatch. Key features of the capnographic waveform include the baseline, rise and contour of the CO2 curve which can provide diagnostic clues about various clinical conditions.
ASA Guidelines for Management of the Difficult Airway
Practice Guidelines for Management of the Difficult Airway
An Updated Report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway
Anesthesiology 2013; 118(2):251-270
Airway assesment IN ANESTHESIA
Upper airway anatomy includes the mouth, nasal cavity, nasopharynx, oropharynx, larynx, and lower airway including the trachea and bronchi. Factors predisposing to a difficult airway include congenital deformities, infections, tumors, arthritis, and injuries. A thorough airway assessment involves history, physical exam including focused tests like Mallampatti score, thyromental distance, jaw mobility, and neck range of motion to identify potential difficulties and plan management.
What's hot (20)
ASA Guidelines for Management of the Difficult Airway
ASA Guidelines for Management of the Difficult Airway
Similar to Advanced airway-management
airwaytoday.ppt
This document discusses strategies for managing difficult airways in emergency situations. It begins by outlining goals of predicting difficult airways, having appropriate plans, and confidence in "can't intubate, can't ventilate" situations. It then discusses factors that can help identify difficult airways through past medical history, physical exam findings like thyromental distance, and classifications like Mallampati. The document emphasizes having alternative plans for airway management if intubation fails, such as BVM ventilation, supraglottic airways, or surgical techniques. It stresses the importance of paramedics feeling prepared with multiple airway options when facing emergent difficult airway scenarios.
Airway assessment in anaesthesia
Airway assessment is important for identifying patients at risk of a difficult airway. Several tests can be used including Mallampati scoring, mouth opening, neck mobility, and thyromental distance. A difficult airway is when facemask ventilation or intubation is not possible using conventional methods. It is important to prepare for difficult airway scenarios by having proper equipment and involving senior help. Identifying difficult airway risks pre-operatively allows time for planning alternative strategies to ensure patient safety.
Pediatric Airways Management
This document provides an overview of pediatric airway management for prehospital providers. It discusses decision making considerations, indications for managing the airway, and debates around prehospital intubation. Key techniques covered include basic life support, intubation approaches and positioning, difficult airway management, and rescue devices. Ventilator management and use of the Broselow tape for equipment sizing are also summarized.
Airway management in for seadtion
This document provides an overview of airway assessment and management. It discusses assessing the airway based on history, physical exam including tests like Mallampati score, and tertiary exams. The goals of airway management are maintaining a patent airway to allow for gas exchange. Difficult airways can occur due to anatomical abnormalities. Proper preparation includes thorough assessment, having a back-up plan, and calling for help if needed. Skills like manual techniques and use of airway devices are important for supporting the airway.
Airway management part 2
1. The document discusses various airway management and ventilation methods for EMS professionals, including risks, indications, techniques, and equipment for procedures like endotracheal intubation, gastric tube insertion, surgical airways, and needle thoracostomy.
2. Specific techniques covered include orotracheal intubation, nasotracheal intubation, digital intubation, surgical cricothyrotomy, needle cricothyrotomy, and chest escharotomy. Alternative airways like combitubes and LMAs are also reviewed.
3. Pharmacological assisted intubation techniques using sedation and neuromuscular blockade drugs are described, along with the risks and procedures involved.
Airway Management 2
1. The document discusses various airway management and ventilation methods for EMS professionals, including risks, protective measures, and techniques for nasogastric tube insertion, endotracheal intubation, surgical airways, needle thoracostomy, and other alternative airways.
2. Specific details are provided on patient positioning, equipment selection, assessing airway difficulty, intubation techniques like orotracheal intubation, confirming endotracheal tube placement, and complications to be aware of for various airway procedures.
3. Pharmacological assisted intubation techniques are outlined, including use of sedation medications and neuromuscular blocking agents as well as risks, contraindications and monitoring considerations for rapid
Advanced Airway Management
This document provides information on various advanced airway management techniques including orotracheal intubation, nasogastric tubes, suctioning, and use of alternative airways like Combitubes. It describes how to perform each technique, important anatomy, sizes of equipment to use, potential complications, and considerations for intubating infants and children due to anatomical and physiological differences from adults.
2020 fun with thoracostomy's
This document provides an overview of chest tube drainage systems and procedures. It begins with learning objectives related to chest anatomy, physiology of breathing, and conditions requiring chest drainage. Needle thoracostomy, simple thoracostomy, and tube thoracostomy are compared and contrasted. Traditional multi-bottle chest drainage systems are described and compared to modern disposable systems. Key steps in setting up chest drainage and ongoing patient care are outlined. Signs for chest tube removal are also mentioned.
Airway assessment and pedictors of difficult airway....must know for anaesthe...
This document discusses the importance of airway management expertise and outlines factors that can indicate a difficult airway. It notes that respiratory events are the second most common cause of injuries in anesthesia practice. Various anatomical measurements and assessments are described that can help predict a difficult airway, including Mallampati score, thyromental distance, neck mobility, and mandibular range of motion. Radiographic assessments like CT scans can also provide useful information. No single test is perfectly predictive, so anesthesiologists must always be prepared for an unanticipated difficult airway.
Trauma Management PPT for MBBS Students by Dr Anil Kumar,AIIMS-Patna
This document discusses trauma management and the burden of trauma in India. It begins with definitions of key terms like trauma, emergency, and triage. It then summarizes trauma statistics from 2005 and 2011 reports, showing over 4 million hospitalizations and 140,000 deaths annually. The document recommends establishing standardized pre-hospital and hospital protocols based on ATLS guidelines to improve outcomes. Key components of trauma management covered include scene safety, triage, primary and secondary surveys, hemorrhage control, spinal immobilization, and hypothermia prevention.
Ep 27 Hobson posture and airway
This document discusses the relationship between restricted breathing mechanics, airway, and posture. It outlines assessments that should be performed to evaluate the temporomandibular joint (TMJ), cervical spine, breathing, and posture. These include tests of joint range of motion, muscle strength, hypermobility, and breathing efficiency. Restricted breathing is found in many patients and is linked to forward head posture. Correcting breathing mechanics and posture can help resolve TMJ and neck pain by restoring proper joint alignment in the upper body.
Prof. Anis Bhatti lecture on DDH evaluation & screening Protocols
Prof. Anisuddin Bhatti, Paediatric Orthopaedic Surgeon, Dr. Ziauddin University Hospital Clifton Karachi, presented webinar on Developmental dysplastic hip, series 1. on <meet.google.com> on 16.10.2020. Presentation mostly for trainees & jr. consultants. He explained in detail, pathoanatomy, screening protocols, ultrasonography & radiological evaluation of DDH cases.
Airway and breathing
The document provides an overview of airway and breathing topics for continuing education. It covers anatomy and physiology of the upper and lower airways, oxygenation and ventilation processes, clinical assessment techniques, and interventions to ensure proper oxygenation and ventilation including positioning, airway adjuncts, bag-valve-mask ventilation, and advanced airway placement like laryngeal mask airways. Key skills like auscultation, suctioning, and assisting ventilation are also reviewed.
Backup airways
- Jaw thrust
- Head extension
Provider:
- Index finger guides mask
- Other hand guides tube
LMA Insertion
Recognition And Management Of Difficult Airway
This document discusses recognition and management of difficult airways. It defines difficult airway as difficulty with mask ventilation or tracheal intubation. It discusses incidence, risk factors, assessment techniques like Mallampati classification and thyromental distance, and management strategies including awake intubation, use of airway adjuncts like LMA, and the ASA difficult airway algorithm which provides a structured approach. The key points are assessing risk factors, having proper equipment and backup plans, and pursuing oxygenation throughout management of a difficult airway.
Asthma Update - Spirometry.pptx
Mr. B, a 55-year-old smoker with a history of unstable angina, was referred for spirometry to evaluate shortness of breath. Spirometry measures lung function by having the patient forcefully exhale into a mouthpiece. It would be an appropriate test for Mr. B's symptoms to evaluate possible lung disease. The document outlines the preparation, performance, and interpretation of spirometry tests, including ensuring patients are properly coached on the technique and that results meet quality standards for accuracy. Spirometry can help diagnose conditions like COPD in smokers with symptoms and guide further treatment.
Airway solutions in trauma scenarios
1) The patient, a 28-year old man involved in a motorbike accident, has an impaired airway as evidenced by snoring, rapid breathing, and low oxygen saturation.
2) The top priority is securing the patient's airway. Basic airway maneuvers and adjuncts like chin lift, jaw thrust, oropharyngeal airway are appropriate first steps given intact reflexes.
3) If the airway cannot be maintained or there is impending compromise, more invasive techniques like intubation may be needed while protecting the cervical spine. Assessing risk factors can help predict difficult airways requiring specialized equipment or procedures like surgical airway.
Airway management
This document discusses various types of breathing circuits and airway management devices. It describes Mapleson breathing circuit classifications and notes that the Magill and Bain systems are efficient for spontaneous and controlled ventilation, respectively. The Jackson Rees or Type F circuit has a larger reservoir bag, allowing for assisted or controlled ventilation, especially in children. The document also outlines various airway assessment techniques, predictors of difficult intubation/mask ventilation, and management strategies and devices for securing the airway, including oral/nasal airways, face masks, laryngeal mask airways, and tracheal intubation equipment.
Critical illness airway management
This document discusses airway management in critical illness. It emphasizes the importance of thorough preparation, optimization of patient physiology, careful equipment selection, effective team communication and consideration of backup plans. Key steps include comprehensive airway assessment, positioning, preoxygenation, hemodynamic support and ensuring adequate monitoring and assistance are available. Difficulties that may arise include hypoxemia, hypotension, failed intubation or inability to oxygenate the patient. Strategies like use of supraglottic airways or surgical airway are discussed for such scenarios. Overall, a methodical approach with a focus on patient safety is recommended for managing critically ill patients requiring intubation.
Ch08 eec3
1. The document outlines the steps for assessing and treating a trauma patient, including distinguishing those with and without significant mechanisms of injury, performing focused exams, and ongoing reassessment.
2. It describes the eight chapters of trauma assessment - scene size-up, initial assessment, primary survey, history taking, secondary survey, monitoring, transportation considerations, and overall hospital assessment.
3. Guidelines are provided for rapid trauma assessment, detailed physical exam, cervical collar application, and determining whether a detailed exam is needed based on the patient's condition and mechanism of injury.
Similar to Advanced airway-management (20)
Airway assessment and pedictors of difficult airway....must know for anaesthe...
Airway assessment and pedictors of difficult airway....must know for anaesthe...
Trauma Management PPT for MBBS Students by Dr Anil Kumar,AIIMS-Patna
Trauma Management PPT for MBBS Students by Dr Anil Kumar,AIIMS-Patna
Prof. Anis Bhatti lecture on DDH evaluation & screening Protocols
Prof. Anis Bhatti lecture on DDH evaluation & screening Protocols
More from Dang Thanh Tuan
07 capnography trends in procedural sedation
1) Procedural sedation is used for many medical procedures and aims to provide analgesia, amnesia, and reduce anxiety while maintaining airway reflexes and spontaneous breathing.
2) While pulse oximetry became standard in the 1980s, capnography has emerged as the new gold standard for monitoring procedural sedation as it can detect respiratory issues that oximetry may miss.
3) Overlake Hospital implemented capnography monitoring for all procedural sedations after reviewing evidence and determining it was more effective for patient safety than relying on respiratory therapists to continuously monitor each procedure.
The evolution of pediatric mechanical ventilators
1. Mechanical ventilators have evolved from simple analog machines to sophisticated microprocessor-controlled devices with advanced modes of ventilation.
2. Early ventilators were open-loop controlled while modern ventilators use various closed-loop and dual-loop control schemes to better match ventilation to patient needs.
3. The newest generations of ventilators use proportional assist, automatic tube compensation, adaptive support ventilation, and other advanced modes that aim to provide more patient-synchronized support and facilitate weaning. However, further research is still needed to fully understand the outcomes of these newer ventilation strategies.
20 patient monitoring
The document discusses various methods of patient monitoring during anesthesia, including their purposes, advantages, and limitations. It covers monitoring vital signs, standards for basic anesthesia monitoring according to the ASA, techniques like non-invasive blood pressure monitoring, ECG, pulse oximetry, capnography, and invasive arterial line monitoring. Key aspects emphasized are integrating multiple monitoring methods to evaluate oxygenation, ventilation, and circulation.
19 introduction of volumetric capnography
The document discusses the introduction and clinical applications of volumetric capnography (VCO2) at one hospital. It provides an agenda for the topics covered, which include VCO2 management, clinical applications, and data from the University of Tennessee Medical Center's experience using VCO2. Key applications discussed are ventilation management, monitoring changes in perfusion, optimization of positive end-expiratory pressure, and assisting with ventilator weaning trials. The University of Tennessee Medical Center saw decreases in length of mechanical ventilation, ventilator days, and re-intubation rates after implementing VCO2 monitoring.
18 basics of pediatric airway anatomy, physiology and management
The document provides an overview of pediatric airway anatomy, physiology, and management. It discusses the differences between pediatric and adult airways, including a more rostral larynx, relatively larger tongue, angled vocal cords, differently shaped epiglottis, and funneled larynx in children. It also reviews normal airway management techniques like bag-mask ventilation and various airway devices, as well as complications from intubation. The goal is to protect, adequately ventilate, and oxygenate the pediatric airway.
17 capnography part4 non-intubated
The document discusses the use of capnography for non-intubated patients experiencing trouble breathing. It describes how capnography can help identify and monitor conditions like bronchospasm from asthma or COPD by examining patterns in exhaled carbon dioxide levels. Specific capnographic signatures are presented for different respiratory conditions including asthma attacks, COPD exacerbations, congestive heart failure, and hypoventilation states. Case studies demonstrate how capnography can track changes in a patient's condition before and after treatment.
16 capnography part3 intubated
Capnography can be used to summarize 3 key applications for intubated patients:
1) It can confirm correct endotracheal tube placement and detect displacement. Characteristic waveforms indicate proper vs displaced placement.
2) During CPR, it can assess the effectiveness of chest compressions by correlating end-tidal CO2 levels with cardiac output and blood flow.
3) It provides an early indicator of return of spontaneous circulation through a rapid rise in CO2 levels, earlier than other signs like pulse or blood pressure. It also aids the decision to cease resuscitation efforts based on CO2 levels.
15 capnography part2 introduction
Capnography measures exhaled carbon dioxide (CO2) to provide real-time monitoring of ventilation, unlike pulse oximetry which monitors oxygen saturation in the blood and is slower to detect changes. A normal capnographic waveform has four phases: 1) dead space, 2) ascending, 3) alveolar plateau, and 4) descending. The end-tidal CO2 value reflects the highest CO2 concentration in exhaled air and typically ranges from 35-45mmHg. Capnography can immediately detect conditions that impact ventilation such as hypoventilation, hyperventilation, and bronchospasm based on changes to the waveform shape, frequency, and CO2 values.
14 capnography part1 overview
This document provides an overview of capnography, which is a technology that objectively measures ventilation by detecting exhaled carbon dioxide. It can be used for both intubated and non-intubated patients to continuously monitor ventilation and the patient's ABCs. The document reviews the history of capnography, from its initial use in operating rooms to new portable technologies suitable for emergency medical services. It also outlines the clinical applications of capnography such as verifying endotracheal tube placement and monitoring treatment effectiveness.
13 icu monitoring standards and capnography
Dr. Ajmal Eusuf discusses the importance and benefits of capnography monitoring in the ICU. Capnography can be used to confirm proper endotracheal tube placement, monitor ventilation, and detect various respiratory issues. While capnography is standard practice in operating rooms and recommended by guidelines, only about half of UK ICUs currently use it as a mandatory monitoring tool. Adopting capnography as routine bedside monitoring in the ICU would help compliance with protocols and better patient care, especially for critically ill patients who are sicker than those in operating rooms.
12 mainstream sidestream capnpgraphy
The document discusses two options for capnography monitoring from ZOLL - the CAPNOSTAT 3 mainstream CO2 sensor and the LoFlo sidestream CO2 module. It provides details on the benefits of each, such as the CAPNOSTAT sensor's accuracy and resistance to contaminants, and the LoFlo module's interchangeability and low 50ml/min sampling rate. The document emphasizes that both provide reliable, accurate CO2 monitoring and waveforms for assessing patient ventilation.
More from Dang Thanh Tuan (20)
Internet cac phuong thuc dieu tri thay the than crrt-vn
Internet cac phuong thuc dieu tri thay the than crrt-vn
18 basics of pediatric airway anatomy, physiology and management
18 basics of pediatric airway anatomy, physiology and management
Recently uploaded
pathology MCQS introduction to pathology general pathology
pathology MCQS introduction to pathology general pathology
Post-Menstrual Smell- When to Suspect Vaginitis.pptx
Do you have abnormal smell after periods? It may be vaginitis. Do not worry, herbal medicine Fuyan Pill can help you get a cure.
Top Travel Vaccinations in Manchester
Travel vaccination in Manchester offers comprehensive immunization services for individuals planning international trips. Expert healthcare providers administer vaccines tailored to your destination, ensuring you stay protected against various diseases. Conveniently located clinics and flexible appointment options make it easy to get the necessary shots before your journey. Stay healthy and travel with confidence by getting vaccinated in Manchester. Visit us: www.nxhealthcare.co.uk
Histololgy of Female Reproductive System.pptx
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Hemodialysis: Chapter 5, Dialyzers Overview - Dr.Gawad
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central
Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa CentralClinic ^%[+27633867063*Abortion Pills For Sale In Tembisa CentralClinic ^%[+27633867063*Abortion Pills For Sale In Tembisa CentralClinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central
Efficacy of Avartana Sneha in Ayurveda
Avartana Sneha is a unique method of Preparation of Sneha Kalpana in Ayurveda, mainly it is indicated for the Vataja rogas.
vonoprazan A novel drug for GERD presentation
Vonoprazan, a new potassium acid channel blocker used in the conditions of GERD and gastric ulcer, duodenal ulcer ....
Cosmetology and Trichology Courses at Kosmoderma Academy PRP (Hair), DR Growt...
Cosmetology and Trichology Courses at Kosmoderma Academy PRP (Hair), DR Growt...Kosmoderma Academy Of Aesthetic Medicine
Kosmoderma Academy, a leading institution in the field of dermatology and aesthetics, offers comprehensive courses in cosmetology and trichology. Our specialized courses on PRP (Hair), DR+Growth Factor, GFC, and Qr678 are designed to equip practitioners with advanced skills and knowledge to excel in hair restoration and growth treatments.
DECLARATION OF HELSINKI - History and principles
This SlideShare presentation provides a comprehensive overview of the Declaration of Helsinki, a foundational document outlining ethical guidelines for conducting medical research involving human subjects.
Ketone bodies and metabolism-biochemistry
This slide consists of all the topics of ketone . This can be used for exam purpose for writing about Diabetic keto acidosis etc . Thank you
Medical Quiz ( Online Quiz for API Meet 2024 ).pdf
This quiz was conducted as a promotional event for the 2024 Annual Meet of Kerala Chapter of API.
More than 20 participants took part everyday !
Demystifying Fallopian Tube Blockage- Grading the Differences and Implication...
Fallopian tube blockage may cause female infertility. For treatment, herbal medicine Fuyan Pill can be a solution.
Recently uploaded (20)
pathology MCQS introduction to pathology general pathology
pathology MCQS introduction to pathology general pathology
Ear and its clinical correlations By Dr. Rabia Inam Gandapore.pptx
Ear and its clinical correlations By Dr. Rabia Inam Gandapore.pptx
Post-Menstrual Smell- When to Suspect Vaginitis.pptx
Post-Menstrual Smell- When to Suspect Vaginitis.pptx
Hemodialysis: Chapter 5, Dialyzers Overview - Dr.Gawad
Hemodialysis: Chapter 5, Dialyzers Overview - Dr.Gawad
Outbreak management including quarantine, isolation, contact.pptx
Outbreak management including quarantine, isolation, contact.pptx
Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central
Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central
CHEMOTHERAPY_RDP_CHAPTER 6_Anti Malarial Drugs.pdf
CHEMOTHERAPY_RDP_CHAPTER 6_Anti Malarial Drugs.pdf
Cosmetology and Trichology Courses at Kosmoderma Academy PRP (Hair), DR Growt...
Cosmetology and Trichology Courses at Kosmoderma Academy PRP (Hair), DR Growt...
Medical Quiz ( Online Quiz for API Meet 2024 ).pdf
Medical Quiz ( Online Quiz for API Meet 2024 ).pdf
Muscles of Mastication by Dr. Rabia Inam Gandapore.pptx
Muscles of Mastication by Dr. Rabia Inam Gandapore.pptx
Demystifying Fallopian Tube Blockage- Grading the Differences and Implication...
Demystifying Fallopian Tube Blockage- Grading the Differences and Implication...
Advanced airway-management
- 1. Advanced Airway Management Part 4 The Difficult Airway By Steve Cole, CCEMT-P
- 2. … So I said “Hey Ya’ll…watch this”…………
- 6. “ A mind once stretched by new Ideas never regains it original dimensions…”
- 10. If only they looked this good…
- 11. Ped and Adult Normal Trachea
- 12. How many of our Pt’s are like That?
- 14. They Tend to look like This:
- 15. And This:
- 16. And This (after failed ETT attempt)
- 17. Most of our Patients are already “difficult airways” by “OR” Standards. Why should EMS personnel try to further identify a difficult airway?
- 31. Cormack & Lehane Grading
- 34. What do we do when we have a difficult airway?
- 36. So what do we do?
- 37. A little pre-planning goes a long way…
Editor's Notes
- Place Axis photo here
- In most cases Pre-hospital airway needs managing regardless of difficulty , and the Paramedic is expected to do that, regardless of difficulty ….so what is the benefit of knowing a Fancy system?