AIRWAY Management

AIRWAY
MANAGEMENT
INTRODUCTION
Airway management are a set of medical procedures preformed in
order to prevent airway obstruction and thus ensuring an open pathway
between a patients lungs and the outside world.
This is accomplished by clearing or preventing obstructions of
airways, often referred to as choking
AIRWAY MANAGEMENT
1.BASIC AIRWAY MANAGEMENT
2.ADVANCED AIRWAY MANAGEMENT
BASIC AIRWAY MANAGEMENT:

Basic techniques are simple to perform even by non-health care
professionals and do not require use of medical equipmen
Basic airway management is mainly used in first aid since it is noninvasive, simple to perform Basic airways management can be divided into
treatment and prevention.
Treatment:
Basic treatment includes a number of procedures aiming at
removing foreign bodies from the airways. Most protocols recommend
encouraging the victim to cough, followed by hard back slaps and if none
of these things work; abdominal thrusts (Heimlich maneuver) or chest t

hrusts.
if they are unconscious, the rescuer should simply place them in the
recovery position
All forms of the recovery position share

basic principles. The mouth is downward so that fluid can drain from the
patient's airway; the chin is well up to keep the epiglottis opened. Arms
and legs are locked to stabilize the position of the patient.
Prevention:
Prevention techniques focuses on preventing the tongue from
falling back and obstructing the airways, such as head-tilt/chin-lift and
jaw-thrust maneuvers, while use of the recovery position mainly prevents
aspiration of things like stomach content or blood. If head-tilt chin-lift
and jaw-thrust maneuvers are performed with any objects in the airways it
may dislodge them further down the airways and thereby cause more
blockage and harder removal.
The head-tilt/chin-lift is the primary maneuver used in any patient in

whom cervical spine injury is not a concern. The simplest way of ensuring
an open airway in an unconscious patient is to use a head-tilt/chin-lift

technique, thereby lifting the tongue from the back of the throat. This is
taught on most first aid courses as the standard way of clearing an airway.
The jaw-thrust maneuver is an effective airway technique, particularly in
the patient in whom cervical spine injury is a concern. The jaw thrust is a
technique used on patients with a suspected spinal injury and is used on a
supine patient. The practitioner uses their index and middle fingers to
physically push the posterior (back) aspects of the mandible upwards
while their thumbs push down on the chin to open the mouth. When the
mandible is displaced forward, it pulls the tongue forward and prevents it
from occluding the entrance to the trachea.
ADVA.NCED AIRWAY MANAGEMENT:

whereas advanced techniques require special training and medical
equipment. Advanced airway management is further categorised in
increasing order of invasiveness into supraglottic devices, such as
oropharyngeal or nasopharyngeal airways, followed by infraglottic
techniques, such as tracheal intubation, and finally surgical methods.
Airway management is a primary consideration in cardiopulmonary
resuscitation, anaesthesia, emergency medicine, intensive care medicine
and first aid. Airway management is covered under "A" In the CAB
mnemonic.
Advanced airway management can be performed "blind" or with
visualization of the glottis e.g. by the use of a laryngoscope. It is frequently
performed in critically injured, ill or anesthetized patients to facilitate
ventilation of the lungs, including mechanical ventilation, and to prevent
the possibility of asphyxiation or airway obstruction.
In roughly increasing order of invasiveness are the use of

supraglottic devices such as oropharyngeal or nasopharyngeal airways,
followed by infraglottic techniques such as tracheal intubation and finally
surgical methods.
Removal of foreign objects:
Foreign objects can be removed with a Magill forceps under

inspection of the airway with a laryngoscope
In advanced airway management foreign objects are either
removed by suction or with e.g. a Magill forceps under inspection of the
airway with a laryngoscope or bronchoscope. If removal is not possible
surgical methods should be considered.
Supraglottic techniques:
Supraglottic techniques includes the use of supraglottic tubes, such as
oropharyngeal (OPA) and Nasopharyngeal airways (NPA),
A nasopharyngeal airway is a soft rubber or plastic hollow tube
that is passed through the nose into the posterior pharynx. Patients
tolerate NPAs more easily than OPAs, so NPAs can be used when the use
of an OPA is difficult, such as when the patient's jaw is clenched or the
patient is semiconscious and cannot tolerate an OPA.[7] NPAs are
generally not recommended if there is suspicion of a fracture to the base
of the skull, due to the possibility of the tube entering the cranium.[8]
However, the actual risks of this complication occurring compared to the
risks of damage from hypoxia if an airway is not used are debatable.[8][9]
Infraglottic:
infraglottic devices pass through the glottis and thereby enter the trachea.
Tracheal intubation, often simply referred to as intubation, is the
placement of a flexible plastic or rubber tube into the trachea to maintain
an open airway
A cuffed endotracheal tube used in tracheal intubation

The most widely used route is orotracheal, in which an endotracheal tube
is passed through the mouth and vocal apparatus into the trachea. In a
nasotracheal procedure, an endotracheal tube is passed through the nose
and vocal apparatus into the trachea
Surgical methods
Surgical methods for airway management rely on making a surgical
incision is made below the glottis in order to achieve direct access to the
lower respiratory tract, bypassing the upper respiratory tract. Surgical
airway management is often performed as a last resort in cases where
orotracheal and nasotracheal intubation are impossible or
contraindicated. Surgical airway management is also used when a person
will need a mechanical ventilator for a longer period. Surgical methods
for airway management include cricothyrotomy and tracheostomy.
A cricothyrotomy is an incision made through the skin and cricothyroid
membrane to establish a patent airway during certain life-threatening
situations, such as airway obstruction by a foreign body, angioedema, or
massive facial trauma.[1

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AIRWAY

BASIC AIRWAY MANAGEMENT:

of these things work; abdominal thrusts (Heimlich maneuver) or chest t

All forms of the recovery position share

The head-tilt/chin-lift is the primary maneuver used in any patient in

an open airway in an unconscious patient is to use a head-tilt/chin-lift

ADVA.NCED AIRWAY MANAGEMENT:

In roughly increasing order of invasiveness are the use of

Removal of foreign objects:

Foreign objects can be removed with a Magill forceps under

A cuffed endotracheal tube used in tracheal intubation

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