Airway Flashcards
What can nurses do for the pts airway
-Identify and remove partial or complete obstructions
-Position airway to maintain patency
-Insert oropharyngeal (gadelle) or nasopharyngeal airway
-Protect cervical spine
Anatomy and physiology
Anatomy
Begins at the nasal cavity then proceeds through the pharynx, past the epiglottis, then into the larynx where the vocal cords are then down the trachea down to the bronchial tree and into the lungs
Physiology
Trachea, bronchi and terminal bronchioles → lungs then split into two lobes which contain alveoli to allow for gas exchange to occur.
Airway assessment
- Vocalisation (can the patient talk)
- Looking for obstructions of the airway:
- Tongue obstructions
- Loose teeth or foreign objects
- Bleeding/secretions/vomitus
- Oedema - Assess establish and maintain an airway
Definition of airway obstruction
Blockage in the airway
-Can be partial or complete (which prevents air from getting into your lungs)
Types of airway obstructions
- Upper airway
- Lower airway
- Partial airway
- Complete airway
- Acute airway
- Chronic airway
Causes of airway obstructions
- Foreign body
- Infection (Tetanus, Diphtheria, Epiglottis etc.)
- Tumour
- Trauma
- Drug induced
- Poison and toxic exposure
Sign of normal breathing
Sign of completely obstructed breathing
Sign of partial obstruction
quiet
silent
noisy
Signs/symptoms of life threatening airway problems
- Dyspnoea, laboured respirations
- Decreased or no air movement
- Cyanosis
- Presence of foreign body in the airway
- Trauma to the face or neck
- Breathlessness/agitation
- Unconsciousness
Indications for airway management
- Apnoea
- Obstruction (tongue, epiglottis, soft pallete)
- Glasgow coma scale <8
- Unstable mid-face trauma
- Airway injuries
- Inability to maintain airway or oxygenation
How can we establish/manage an airway
- correct head position.
- Head-tilt/chin-lift or jaw thrust
- Remove any foreign objects
- Suction
- Insert an airway
- Endotracheal Intubation
- Needle or surgical airway (cricothyrotomy)
Airway adjuncts
- Oral airway (oropharyngeal= guedel)
- Nasal airway (used when oropharangyl airway is difficult
- Endotracheal tube
- Laryngeal mask airway (LMA) (short term, does not protect against sources of aspiration from above the larynx)
- Surgical airway
- Bag mask ventilation (2 person tecnhique)
Nursing responsibilities in airway management
- Tube security/tube markings/monitoring
- Patient positioning
- Sedation and pain relief (bronchodilators, inhaled corticosteroids, SABA)
- Oral hygiene
- Gastric tube insertion
- Humidification
- Intubated pts. Should never be left alone
- Familiarity with equipment, drugs and the intubation procedure
