Management of the airway, ventilation and choking Flashcards
What are signs of airway obstruction?
Use of accessory muscles causing see-saw pattern of chest- chest drawn in and abdomen expands on inspiration and opposite on expiration.
Noise- partial obstruction will be grunting/wheezing/stridor. Complete obstruction complete silence
No airflow when hand held over the mouth
What position should the head be placed in to ensure airway is optimised?
Infant- neutral position
Child- sniffing position
Jaw thrust
What is the maximum level of suction in babies?
120mmHg
What are OPAs intended for?
Unconscious patients
Otherwise risk of aspiration/laryngospasm
How do you determine the size of an NPA
From the nostrils to the tragus
When should NPAs be used?
For conscious patients or patients who conscious levels could improve quickly
When are NPAs contraindicated?
In base of skull fractures or coagulopathy
When should a non rebreathe mask with reservoir be used?
For an ill child who is breathing spontaneously
When should blow by oxygen be used?
For children who are anxious and not tolerating the face mask. Carer holds the mask close to the face
What is the normal resp rate for a child less than a year?
30-40 per min
What is the normal resp rate for a 1-2 year old?
26-34 per min
What is the normal resp rate for a 2-5 year old
24-30 per min
What is the normal resp rate for a 5-12 year old?
20-24 per min
What is the normal resp rate for children >12?
12-20 per min
What should be done if a child is choking?
If child is coughing then encourage the child to do so- if child stops coughing or becomes too weak then need to intervene
What are signs of an effective cough?
Crying or verbal response to questions
Loud cough
Able to take a breath between coughs
Fully responsive
What are signs of an ineffective cough?
Unresponsive
Quiet or silent cough
Cyanosis
Unable to breathe
Unable to vocalise
What should be done if a infant is choking with an ineffective cough?
Infant back blows- place child head down over lap. Support the head. give 5 blows between shoulder blades (check after each blow if obstruction has cleared)
Infant chest thrust- Turn infant onto back. Administer 5 chest thrusts (like chest compressions but sharper and harder . Check after each thrust the obstruction is relieved.
What should be done if a child is choking with an ineffective cough?
Child back blows
Child abdominal thrust- stand behind child and arms around between umbilicus and xiphisternum. Grab hands and pull inwards and upwards in short sharp thrusts- 5 times.
Ensure check if obstruction is cleared between each thrust
