Airway Management and Ventilation Flashcards
For an athelte with reduce conscious level, what process should be used to assess airway obstruction?
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Look, listen and feel.
What are you looking for in the “look Stage”?
During inspiration, the chest should be seen to rise, as the lungs inflate. The abdomen should also rise as the diaphragm contracts, moving downwards forcing the anterior abdominal wall to rise.
If the airway is occluded, the chest may still rise due to chest wall muscle activity, but the abdomen will be “sucked” inwards due to the negative intrathoracic pressure generated by the chest wall movement. This creates a so-called “see-saw” pattern of respiration.
Inspecting the oropharynx
What are you looking for in the “Listen Stage”?
Listen for the presence of breath sounds, as well as the presence of added sounds. Gurgling noises imply fluid in the airway. This may be secretions, blood, vomit or gastric contents. Snoring or stridulous noises imply the presence of upper airway obstruction. Wheeze implies lower airway obstruction.
It is important not to be falsely reassured by the complete absence of any sounds, or by initial obstruction noises becoming quieter – this may indicate complete (or near complete) airway obstruction.
What are you looking for in the “Feel Stage”?
The practitioner should feel for expired air from the athlete’s mouth and nose.
How can you assess the look, listen and feel in one ?
The practitioner should hold their own head above the athletes head, turned to look down the chest. This will allow inspection of the chest and abdomen for movement, at the same time as listening for breath sounds and abnormal airway noises, and as feeling for expired air on the cheek.
What are the two options to open/ clear and airway, and describe when they would be used.
Head Tilt + Chin Lift -Pateint with no CX implication
Jaw Thrus - possoble Cx issues.
If you need to bypass the airway, what are the two adjuncts avaliable ?
Nasopharyngeal airway - Sized to inner nose diamiter and interted slowly with twisting to overcome resistance.
Oropharyngeal airway (OPA) - Insterted correct way over depressed tounge.
What are the three option for providing ventilation to an athlete ?
The pocket face mask.
The pocket face mask with bag valve attached.
I-gel® airway.
Protacal for airway check?
Look for obstruction
Remove if possible (pump, gumshield ect).
Open airway, jawthrust or tilt.
If unsucsessfuall use adjunct suitable - Nasal or mouth.
Insert and re-assess.
If an deteriation attemtp other airway, followed by reasses - look, listen, feel.
If further deteriation, use I gel with bag valve if avalaible.
