Airway management Flashcards
Describe anatomy of upper airway
signs: obstructed airway
paradoxical chest/abdo movements
cyanosis
stridor
curgling
accessory muscles
signs: partial v complete airway obstruction
LOOK: paradoxical chest/abdo movemenets and cyanosed v no movement
LISTEN: noisy breathing (stridor, snoring) v silent
FEEL: some air movement v no air movement
cause: collapsed airway in unconscious patient
loss of airwat muscle tone
causes: upper airway obstruction
- CNS depression
- foreign body aspiration
- infection (epiglottitis, tracheitis, croup etc)
- haemorrhage/haematoma
- trauma
- burns
- neoplasm
- congenital
- NMD
resus uk choking guideline
- mild with effective cough - encourage cough and check for deterioration to ineffective cough or obstruction relieved
- severe and conscious = 5 back blow and 5 abdominal thrusts
- sever and unconscious = start CPR
steps to open airway
- head tilt, chin lift
- jaw thrust
- nasopharyngeal airway if semi-unconscious
- oropharyngeal if unconscious
- supraglottic device/LMA
- ET tube
contraindications: oropharyngeal airway adj
conscious with gag reflex in tact
stimulates vomiting which can further obstruct airway
contraindications: nasopharyngeal airway adj
base of skull #
trauma to nose (eipstaxis etc)
measure oropharyngeal airway adj
inscisor teeth to angle of mandible
measure nasopharyngeal aiwary adj
tip of patient’s nose to earlobe
adv: LMA over ET
- quicker insertion
- easier insertion
- less CVS stimulation
- lower frequency of cough reflex on insertion
- lower incidence sore throat
- can be used outside of operating theatre - more user friendly
diadv: LMA over ET
- not secure - higher risk of aspirating
- gastric insufflation more likely
- can cause laryngospasm
- air leak
contraindications: LMA
non-fasted patient
severe GORD
morbidly obese
pregnancy
obstructive/abnormal lesions in oropharynx
increased airway resistance and decreased lung complicance
check: igel in correct position
- teeth resting on bite block (incisors)
- tip of igel in upper oesophageal opening
- cuff located against laryngeal framework in hypopharynx