Airways Flashcards
What to look for when assessing airway?
Look for noisy airway
- Tongue (only during unconsciousness) – snoring noise
- Partial obstruction signs – snoring, airway whistling, gurgling
- Or no airflow at all
Feel for air movement.
Airway steps?
Look for obstruction
Suction
Position the patient
Use airway adjuncts.
Info on suctioning
- Clear the airway before opening it
- Yanker catheter or soft catheter.
- Only suction as far down as you can see and withdraw the catheter as you suction.
- < 10 seconds.
Info on positioning
- Sniffing the air position using chin lift and head tilt.
- Used in non-trauma patients
- Cup head in palm of hand
- Two fingers on hard bony part of chin.
- Tongue lifted from back of pharynx.
Positioning if spinal injury suspected
Jaw thrust
- Clinician positioned at patients head.
- Middle fingers on angle of jaw.
- Thumbs on zygomatic arches, lift mandible.
- Tongue lifts up from back of pharynx.
What is Triple Airway Manoeuvre?
- Jaw thrust combined with head tilt and chin lift.
Recovery position useful?
- Useful is patient is having a seizure.
- OR need to use ‘postural drainage’ to clear the airway.
- Don’t do this is you suspect trauma to spine or head.
Other position info?
Ramping
The angle of head matches ear to sternum
Head elevation.
Airway adjunct info?
- Prevents tongue from obstructing the airway (covering the epiglottis)
Oropharyngeal airway OP
Nasopharyngeal Airway NP
Oropharyngeal airway info?
Measure and fit an OP
Used for an unresponsive patient with an absent gag reflex
Contraindication: if patient’s gag reflex is intact.
Closely monitor the patient for new airway obstruction (saliva, vomit, blood…), as an OP will NOT protect the airway from this.
Aspiration could occur.
For paediatrics - no twist.
Nasopharyngeal airway info?
- NP inserts into nose at 90 degrees to patients face.
- Links the nostril and pharynx.
- Small adult – use size 6.00mm.
- Large adult – 7.00mm.
Indications: If patient has trismus. (Reduced jaw opening due to muscle spasm, or OP not tolerated)
Relative contraindications: ongoing resistance, not tolerated, patient on anti-coagulants.
CONTRAINDICATED: in under 12 years of age. (at EEast)
Cautions: maxillofacial injury and suspected skill fracture, epistaxis on insertion of NP.
Insertion of NP?
- Select correct size and lubricate.
- Put bevel next to septum (centre of nose)
- Insert at 90 degrees angel to patients face, rotating back/forth.
- Don’t force – if resistance felt, try other nostril or cease.
What is aspiration?
When something enters your airway or lungs by accident.
BVM info?
- Two handed technique is better for the mask.
- Small slow squeeze over 1-2 seconds duration using 1 hand only.
- Fill reservoir bag with O2 first.
- Don’t over squeeze the bag. – can cause barotrauma.
- Entire volume is 1000ml
PEEP?
Positive end-expiratory pressure (PEEP) is the alveolar pressure above atmospheric pressure that exists at the end of expiration.
