Mod D Tech 16 16 Airway Management

Question 1

Airway management must be

Answer 1

Airway management must be rapid and effective.

Stepwise airway management employs a series of increasingly complicated manoeuvres to open and maintain the airway, used in stepwise order; the simplest, quickest and least invasive first.

Question 2

Name Manual methods of Airway Control

Answer 2

• Recovery position
• •Head tilt / Chin lift
• •Trauma chin lift
• •Trauma jaw thrust
• •Suction / manual clearance

Question 3

recovery Postion

Answer 3

Question 4

Head Tilt/Chin Lift

Answer 4

Question 5

Jaw thrust

Answer 5

Question 6

Airway Adjuncts inc.
What does SAD stand for

name devicies

Answer 6

Supraglottic Airway Devices (SAD)

• Oropharyngeal Airway
• Nasopharyngeal Airway
• •Laryngeal Mask Airway
• I-Gel

Question 7

Indications for the
use of an OPA

Answer 7

•To maintain a patent (open) airway by preventing the tongue from covering the epiglottis which could prevent the patient from breathing

•

•As a person becomes unconscious, the muscles in their jaw relax and allow the tongue to obstruct the airway

Question 8

Sizing an OPA

Inserting an OPA

Answer 8

•Open patient’s airway using cross finger technique

•

• Insert ‘upside down’ (curved end along the roof of the mouth) and using the hard palate as a guide, advance until tip approaches back of the mouth
• Rotate 180 degrees and continue to insert until the flange comes to rest at the teeth

Question 9

Paediatrics OPA

Answer 9

•In children – insert the ‘right way up’ – why do you think this is?

•

Anatomical differences:

Larger tongue

Narrower airways – more easily obstructed

Longer floppy epiglottis

Larger occiput

Question 10

Complications/Hazards for OPA

Answer 10

• Vomiting
• •Can worsen airway obstruction – if placed incorrectly can depress tongue into the back of the pharynx, further blocking the airway
• Can cause trauma to the mouth – injury to hard or soft palate (tearing, bleeding etc)
• Can cause pharyngeal stimulation with coughing or vomiting
• •Laryngospasm

Question 11

Contraindications

Answer 11

• In patients with a cough or gag reflex
• •Clenched teeth / trismus
• •Oral trauma
• •Conscious or semi-conscious patient

Question 12

Important points

Answer 12

•Clear mouth and pharynx before insertion

•

•Withdraw if patient rejects insertion

•

•Check that air is passing through it once inserted

•

•Maintain careful observation to ensure the lumen stays clear

Question 13

Nasopharyngeal
Airways (NP airway)

Nasopharyngeal Airways

Answer 13

NP airways are to be used when an OPA will not be tolerated such as in the following circumstances:

• Fitting or seizures
• Suspected cervical spine injury
• Awake or semi-conscious state
• Active gag reflex
• Trismus

Question 14

Contra-indications N.P. airways must not be used in

Answer 14

N.P. airways must not be used in:

• Patients with nasal injury
• •Cases of recurrent nose bleeds or nasal polyps
• •Children < 12 years

Question 15

Caution

N.P. airways

Answer 15

Question 16

Base of skull # indicators

Answer 16

Question 17

Possible Complications NPs

Answer 17

• Nasal bleeding
• •Laryngospasm and vomiting
• •Ineffective airway

Question 18

Measuring an NPA

Answer 18

Question 19

Nasopharyngeal airway insertion

Answer 19

• Oxygenate the patient
• •Select and lubricate the airway
• •Position patient in “sniffing the morning air” position
• Lubricate, gently insert into patients largest nostril (Usually right) perpendicularly
• Slide with slight twisting motion into nostril until flange sits against opening

Question 20

Reassess

Answer 20

• Airway adequate
• •Breathing adequate
• •Suction as appropriate
• •Oxygen via non re-breathing mask
• •Monitor the patient constantly

Question 21

IGEL Indications for use ?

Contraindications ?

Answer 21

• Stepwise airway approach
• •Securing and maintaining a patent airway in emergency situations
• •Personnel should be suitably trained and experienced in the use of airway management techniques
• •Paediatric use in extreme circumstances when all other methods have failed

Contraindications

• Trismus
• •Active gag reflex
• Limited mouth opening
• Trauma or mass

Question 22

Removal IGEL

Answer 22

Do not attempt to forcibly remove the device if the patient is biting on it.

Wait until the patient, on vocal command, has fully opened their mouth or opens it spontaneously

Question 23

Question 24

Question 25

Suction Equipment

Answer 25

•There are many different types of suction equipment in use within the Ambulance Service

•

• The operating principle for all is the same.
• The equipment creates a vacuum within the apparatus and a catheter then aspirates substances into a container

Question 26

Suction Types of Catheter

Answer 26

Question 27

When to use Suction

Answer 27

• Regurgitation in the unconscious patient
• •Excessive sputum
• Blood from:
• Maxillo facial injury
• Head injury
• Epistaxis

abdominal haemorrhage

•Saliva in patients who have difficulty in swallowing due to:

• Cerebral haemorrhage
• Oesophageal obstruction
• Injuries to the pharynx
• •Clearance of oropharyngeal airway

Question 28

Failing to use Suction could lead to

Answer 28

• Airway obstruction
• •Stomach contents entering the lungs
• •Pneumonia
• •Lung collapse

Question 29

Use of Suction Equipment and Catheters

Answer 29

• Store flexible catheters so they do not kink
• •Use only sterile catheters – Do not remove from packet until needed
• Insert catheter first, then switch on the suction unit
• •Do not touch the end of the catheter that will be inserted into the patient’s mouth

Question 30

Use of Suction Equipment
and Catheters

Answer 30

•Gently rotate the catheter backwards and forwards to prevent it adhering to soft tissue

•

• After use, suck clean water through the catheter
• •Suction should only be applied for a few seconds at a time

General points:

• Reduce the pressure for children
• •Do not allow the reservoir to overfill
• •When using suction on a poisoned casualty, retain a sample for analysis

Question 31

Answer 31

Question 32

Answer 32

Question 33

Answer 33

Question 34