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EP: Orientation to Airway > The Vortex Approach > Flashcards

The Vortex Approach Flashcards

1
Q

Outline the principles of the Vortex tool

A
  • 3 upper airway lifelines (non-surgical techniques) by which alveolar oxygen delivery can be established and confirmed:
    –> FM
    –> SGA/LMA
    –> ETT
  • Maximum 3 tries at each NSA
    –> at least one of these attempts should be performed by the most experienced clinician
  • For each NSA technique there are 5 optimisations that can be utilised:
    –> manipulations
    –> adjuncts
    –> change size/type
    –> suction
    –> muscle tone
  • Failure at any lifeline necessitates spiral movement down to next lifeline
  • If best effort at each of these lifelines fails then CICO situation exists and neck rescue (surgical airway) must occur
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2
Q

List the three upper airway lifelines of the Vortex approah

A
  1. FM
  2. SGA/LMA
  3. ETT
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3
Q

How many attempts can be made at each upper airway lifeline? What happens if these fail?

A
  • Maximum 3 tries at each NSA
    –> at least one of these attempts should be performed by the most experienced clinician
  • If best effort at each of these lifelines fails then CICO situation exists and neck rescue (surgical airway) must occur
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4
Q

List the five optimisation categories

A

–> manipulations
–> adjuncts
–> change size/type
–> suction
–> muscle tone

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5
Q

What are the primary and secondary goals of upper airway lifelines?

A

PRIMARY: alveolar O2 delivery

SECONDARY: airway protection, airway security, CO2 elimination

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6
Q

What is referred to by ‘best effort’ with regards to the Vortex approach

A

All viable strategies to facilitate success at entering the green zone via a given lifeline have been implemented

–> If the green zone has not been entered following a completed best effort a particular lifeline, no further attempts at that lifeline should occur

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7
Q

Should all optimisation strategies be attempted for a particular lifeline?

A

No, only those beneficial in the given context should be attempted

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8
Q

For FM: outline optimisation strategies for MANIPULATIONS

A

Head and neck:
- Sniffing position / jaw thrust / bed height
- Dentures in

Larynx:
Laryngeal manipulation / ease cricoid

Device:
- 2 hands
- Cuff inflation
- Vice grip

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9
Q

For FM: outline optimisation strategies for ADJUNCTS

A
  • OPA
  • NPA
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10
Q

For FM: outline optimisation strategies for CHANGE SIZE/TYPE

A
  • Change size FM
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11
Q

For FM: outline optimisation strategies for SUCTION

A
  • Suction
  • O2 flush / increase O2 flow
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12
Q

For FM: outline optimisation strategies for MUSCLE TONE

A
  • Consider adequacy of anaesthesia / muscle relaxant
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13
Q

For SGA/LMA: outline optimisation strategies for MANIPULATIONS

A

Head and neck:
- Sniffing position / jaw thrust / bed height
- Pull tongue forward

Larynx:
- Laryngeal manipulation / ease cricoid

Device:
- Twist
- Cuff inflation

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14
Q

For SGA/LMA: outline optimisation strategies for ADJUNCTS

A
  • Fingers
  • Introducer / laryngoscope
  • Bougie
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15
Q

For SGA/LMA: outline optimisation strategies for CHANGE SIZE/TYPE

A

SGA

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16
Q

For SGA/LMA: outline optimisation strategies for SUCTION

A
  • Suction foreign material
17
Q

For SGA/LMA: outline optimisation strategies for MUSCLE TONE

A
  • Consider adequacy of anaesthesia / muscle relaxant
18
Q

For ETT: outline optimisation strategies for MANIPULATIONS

A

Head and neck:
- Sniffing position / jaw thrust / bed height
- Dentures out

Larynx:
- Laryngeal manipulation / ease cricoid

Device:
- Life epiglottis
- Pickaxe grip
- Rotate

19
Q

For ETT: outline optimisation strategies for ADJUNCTS

A
  • Stylet
  • Bougie
  • Magill forceps
20
Q

For ETT: outline optimisation strategies for CHANGE SIZE / TYPE

A
  • Blade / handle / video laryngoscope
  • ETT / bougie with lumen
21
Q

For ETT: outline optimisation strategies for SUCTION

A
  • Suction foreign material
22
Q

For ETT: outline optimisation strategies for MUSCLE TONE

A
  • Consider adequacy of anaesthesia / muscle relaxants

EP: Orientation to Airway (8 decks)

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