Artificial Airways Flashcards
ROLE OF RT IN AIRWAY MANAGEMENT
Providing respiratory care through the
use of bronchodilator therapy, oxygen
therapy, Bi-PAP, ventilator
management.
ROLE OF RT IN AIRWAY MANAGEMENT
Performing airway clearance
management, CPT via the use of the
different equipment and precusser.
Respiratory Therapists play an integral
role in the
Code Response Team
assissting the MD with all intubations
that take place.
A device to relieve upper airway
obstruction.
OROPHARYNGEAL
Should be used in patients who are
sedated or unconscious.
OROPHARYNGEAL
TYPES OF OROPHARYNGEAL
- Berman airway
- Guedel airway
- Cath-Guide Guedel airway
Has external side channel
Berman airway
Has one large internal
channel
Guedel airway
Has 3 internal channels
Cath-Guide Guedel airway
SELECTION OF OROPHARYNGEAL AIRWAY
May be estimated by:
- The distance from the center of the
mouth (or central incisors) to the angle
of the jaw - The corner of the mouth to the earlobe
INSERTION OF OROPHARYNGEAL AIRWAY
Ensure that the patient is
sedated or
unconscious
If the patient begins to gag or retch
during the procedure,
remove the airway
immediately and reassess the necessity
of an oropharyngeal airway
INSERTION OF OROPHARYNGEAL AIRWAY
The patient should be in a
supine
position, and the mouth is open
If a tongue blade is available, the tongue
is ____ and the oropharyngeal
airway may be inserted
depressed
with thepharyngeal curvature
Some practitioners prefer to insert the
airway into the patient’s mouth upside
down so that the
distal end of the airway
is facing the hard palate (roof of the
patient’s mouth)
As the airway is inserted fully, it is
turned 180° until the flange (proximal
end) rests on the patient’s lips or teeth
If oropharyngeal airway is given to conscious patient, it will lead
to irritation and could cause the patient
to gag, vomit or aspirate of gastric
contents (vomitus)
prevent patient from biting
the artificial airway
Bite block
artificial airway Too large –
causes Obstruction
artificial airway Too small –
Can’t serve its purpose
Is a simple airway adjustment that ca be
used to facilitate ventilation and removal
of secretions
NASOPHARYNGEAL AIRWAY
NASOPHARYNGEAL AIRWAY is also a
nasal trumphet or nasal horn
Can be used in patients with an intact gag reflex, unstable fractures of the mandible, trimus (lockjaw), or oral trauma
NASOPHARYNGEAL AIRWAY
Prior to insertion of a nasopharyngeal
airway, the nares should be
inspected
for obstruction
INSERTION OF NASOPHARYNGEAL AIRWAY
A local anesthetic spray may be applied
to the
posterior nares for patient comfort
Prior to nasopharyngeal insertion, the patient should be
in a
sitting or semi-fowler position and
the nares are lifted to reveal the nasal
airway
Placement of the nasopharyngeal airway should be
parallel to the nasal floor, rather the
upwards toward the cribform plate of the
ethmoid bone
Lubrication with a _____ and _____ should
facilitate the insertion of nasopharyngeal airway
water-soluble
lubricant
gentle rotation
since nasopharynx i sHighly vascular could lead to
bleeding or
soft tissue damage (multiple attempts)
Nares must be lifted –
Sniffing position
Lubricant in nasopharyngeal airway insertion–
KY gel
A tube with a small cushioned mask on the
distal nd that provides a seal over the
laryngeal opening
LARGE MASK AIRWAY (LMA)
Is a reusable device, made primarily of medical-grade silicone rubber and is latex-
free
LARGE MASK AIRWAY (LMA)
With proper care and sterilization, it can be
reused up to 40 times
LARGE MASK AIRWAY (LMA)
LMA CONTRAINDICATIONS
Does not protect an airway from the
effects of
reguritation and aspiration
LMA CONTRAINDICATIONS
Should not be used in patients who _____
have not fasted (18 hours)
LMA CONTRAINDICATIONS
Should not be used in patients who are
not
profoundly unconscious and in those
with severe oropharyngeal trauma
INSERTION OF LMA
Prior to insertion of LMA, the patient is
in a supine position, and the head is
advanced slightly
INSERTION OF LMA
The chin is
depressed to open the
mouth
INSERTION OF LMA
with the cuff _______, the lma is inserted blindly without a laryngoscope through the _____
completely deflated or partially inflated
mouth and advanced along the hard palate
INSERTION OF LMA
LMA is then further advanced to the
posterior pharynx and turned toward the
trachea and larynx
INSERTION OF LMA
lma may be guided with fingers
to ascertain that it makes the proper turn
For surgical or OR patients
lma
lma External adapter size –
15mm ED
maneuver to insert the ET tube
Sellick maneuver –
Large Male (Largest possible size):
7.5 - 8.0
Female tube size:
7.0 – 7.5
Special airway for independent
ventilation.
DOUBLE LUMEN ENDOTRACHEAL TUBE (DLT)
DLT has
2 separate lumens
2 cuffs
2 pilot balloons
only 1 lung is sick, other is healthy
unilateral lung disease
DLT provide independent lung ventilation
where isolation of the lung is described
in order to prevent
lung to lung spillage of
blood or pus.
DLT selection
28 and 38 fr are suitable for small childreb
bad lung down, good lung up for patients with
lung abscess, pulmonary interstitial emphysema (pie)
GLDBLU if patient has no
lung abscess or PIE
