Airway Management and Ventilation Flashcards
Assessment of airway obstruction?
LOOK for chest and abdominal movements
LISTEN and FEEL for airflow at mouth and nose
Noises in partial airway obstruction?
Inspiratory stridor (obstruction at level of laryngeal or above)
Expiratory wheeze (obstruction of lower airway)
Gurgling (liquid in upper airways)
Snoring (pharynx partially occluded by tongue or palate)
Signs in complete airway obstruction?
Paradoxical chest and abdominal movements
Management of tracheostomy blockage?
Remove foreign material from tube/stome
Remove tracheostomy tube (inner liner)
Try to pass suction catheter to perform tracheal suctioning
Exchange tracheostomy tube or ventilate with bag and mask (sealing stoma)
Treatment of adult choking - mild airway obstruction?
Encourage cough
Continue to check for deterioration or until relieved
Treatment of adult choking - severe airway obstruction and conscious?
5 Back Blows
5 Abdominal Thrusts
Continue to alternate between
If unconscious - CPR + laryngoscopy with removal of foreign body with Magill’s forceps
What are basic airway opening techniques?
Head tilt and chin lift
Jaw thrust
Adjuncts for basic airway techniques?
Orophayngeal airway (Guedel)
- sizing with distance from incisor to angle of jaw
- unconscious patients
- insert upside down until junction between hard and soft palate then rotate 180 degrees and advance until its in pharynx
Nasopharyngeal Airway
- not deeply unconscious
- CI skull base fracture
- Size 6-7mm
Supraglottic airways - iGel airways - technique?
Sizes 3-5, 4 for most adults
Lubricate back, sides and front of cuff
iGel cuff faces chin of patient
Patient in sniffing morning position, press chin down to open mouth
Push and glide downwards along hard palate with continuous push
Incisors resting on integral bite block with teeth position on iGel
Supraglottic airways - LMA - benefits
Like with iGel - useful in cannot ventilate, cannot intubate scenario
Post tracheal intubation procedures?
Connect to self inflating bag and ventilate at highest possible concentration
Inflate cuff just enough to stop air leak
Confirm placement - clinical assessment and waveform capnography
Continuous ventilation with high concentration oxygen until ROSC
Secure tube with bandage and tie
Clinical assessment of confirming airway position?
Bilateral chest expansion and ausculation
No breath sounds over epigastrium
Misting of tube is unreliable!
Waveform capnography is reliable in confirming position (should have trace and CO2 during CPR)
When would cricothyroidotomy be suitable?
Extensive facial trauma or laryngeal obstruction caused by oedema (anaphylaxis or foreign material)
Surgical performed until semi-elective intubation or tracheostomy is performed
Tracheostomy is contraindicated in emergency due to time taken
