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airway management recorded for S2.pptx
- 2. Basics of Airway Management Anesthesia and Surgical Intensive Care Department
- 3. European Resuscitation Council Track score - a score of > 4 triggers a review by doctor Objectives: Identify the causes of airway obstruction and how to recognize Review basic airway maneuvers Airway Adjuncts, Advanced airway devices Indications, limitation, proper sizing and insertion technique of each Ventilation & oxygen delivery devices
- 5. European Resuscitation Council Recognition of airway obstruction (Look, listen and feel) Talking Difficulty breathing, distressed, choking Shortness of breath Noisy breathing stridor, wheeze, gurgling See-saw respiratory pattern, accessory muscles Airway
- 7. European Resuscitation Council Basic techniques of Airway opening Head tilt, Chin lift
- 8. European Resuscitation Council Basic techniques of Airway opening Jaw thrust (with cervical injury)
- 9. European Resuscitation Council Airway Adjuncts Oropharyngeal airway Size selection distance between the patient’s incisors and the angle of the jaw or the distance between lobule of the ear and the angle of the mouth.
- 10. European Resuscitation Council Airway Adjuncts Oropharyngeal airway Insertion technique upside down position
- 11. European Resuscitation Council Airway Adjuncts Nasopharyngeal airway better tolerated by the patient than oropharyngeal airway. Indicated in patients with clenched jaw, trismus and maxilla facial injuries. Contraindicated in patient with fracture base of the skull.
- 12. European Resuscitation Council Airway Adjuncts Nasopharyngeal airway Selection of the size depends on the patient’s little finger or anterior nares. Size 6-7 mm is suitable for adults.
- 13. European Resuscitation Council Side effects: *Bleeding (30% of cases) *If the tube is long, it stimulates laryngeal reflexes resulting in laryngeal spasm or vomiting. Airway Adjuncts Nasopharyngeal airway
- 15. European Resuscitation Council Ventilation Mouth to mask (pocket mask) Transparent Unidirectional valve (direct expiration from the rescuer) Port for oxygen 2 hand technique maximize the seal
- 16. European Resuscitation Council Ventilation Bag valve mask (BVM) (Self inflating bag) Ventilate either with air or oxygen Single person technique 2 persons technique
- 19. European Resuscitation Council Advanced devices LMA (Laryngeal Mask Airway) Advantages: Used by nursing, paramedical and medical staff Decreases the risk of gastric inflation and regurgitation. Device of choice in suspected cervical spine injury. insertion not require head extension used if tracheal intubation is failed and bag mask ventilation is impossible.
- 20. European Resuscitation Council LMA insertion Select the appropriate size 5 for adult male - 4 for female. Holding the mask like a pen Advance the tip behind the upper incisors with the upper surface applied to the palate until it reaches the posterior pharyngeal wall, press the mask downwards
- 21. European Resuscitation Council Inflate the cuff [(size -1) x 10] Fix the mask. Auscultate the chest, a small leak is acceptable. LMA (Laryngeal Mask Airway)
- 22. European Resuscitation Council Limitations : Significant leak and hypoventilation is caused in pulmonary oedema, bronchospasm and COPD. Risk of aspiration (Theoretically) Laryngeal spasm if not deeply unconscious patient. Airway obstruction by the epiglottis folding down to cover the laryngeal inlet. LMA (Laryngeal Mask Airway)
- 24. European Resuscitation Council Clear, Patent & Safe •Open airway •Basic techniques •Simple adjuncts •LMA •Suction ? Fracture C-spine Airway Management: summary Oxygen therapy
Editor's Notes
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