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    Airway Management

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    Owy
    The document discusses various techniques for managing and securing the airway. It describes how to open the airway using basic maneuvers like head tilt and chin lift. Various airway devices are introduced like oropharyngeal airways, nasopharyngeal airways, laryngeal mask airways, and endotracheal tubes. The steps for intubating a patient are outlined. Difficult airway situations and alternative techniques like cricothyrotomy and tracheostomy are also summarized. The document provides an overview of respiratory anatomy and physiology and maintaining a patent airway.

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    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd

    Airway Management

    Uploaded by

    Owy
    466 views42 pages
    The document discusses various techniques for managing and securing the airway. It describes how to open the airway using basic maneuvers like head tilt and chin lift. Various airway devices are introduced like oropharyngeal airways, nasopharyngeal airways, laryngeal mask airways, and endotracheal tubes. The steps for intubating a patient are outlined. Difficult airway situations and alternative techniques like cricothyrotomy and tracheostomy are also summarized. The document provides an overview of respiratory anatomy and physiology and maintaining a patent airway.

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    The document discusses various techniques for managing and securing the airway. It describes how to open the airway using basic maneuvers like head tilt and chin lift. Various airway devices are introduced like oropharyngeal airways, nasopharyngeal airways, laryngeal mask airways, and endotracheal tubes. The steps for intubating a patient are outlined. Difficult airway situations and alternative techniques like cricothyrotomy and tracheostomy are also summarized. The document provides an overview of respiratory anatomy and physiology and maintaining a patent airway.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    466 views42 pages

    Airway Management

    Uploaded by

    Owy
    The document discusses various techniques for managing and securing the airway. It describes how to open the airway using basic maneuvers like head tilt and chin lift. Various airway devices are introduced like oropharyngeal airways, nasopharyngeal airways, laryngeal mask airways, and endotracheal tubes. The steps for intubating a patient are outlined. Difficult airway situations and alternative techniques like cricothyrotomy and tracheostomy are also summarized. The document provides an overview of respiratory anatomy and physiology and maintaining a patent airway.

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    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
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    You are on page 1of 42

    Owymardyan Y Manafe

    1015018
    Juni Royntan T 1015070

    ANATOMY OF THE RESPIRATORY SYSTEM

    Respiration

    VENTILATION

    WHAT HAPPENED DURING


    VENTILATION

    DEAD SPACE

    ADEQUACY OF THE AIRWAY

    Patency
    Protective reflexes
    Inspired oxygen concentration
    Respiratory drive

    PROBLEM RECOGNITION
    Type of Trauma

    Head Trauma
    Maxillofacial Trauma
    Neck Trauma
    Laryngeal Trauma

    Airway Obstruction

    Agitated
    Cyanosis
    Noisy breathing
    Trachea location

    Inadequacy of
    Ventilation
    Chest movement
    Decreased breath
    sound
    Pulse oximeter

    Airway management

    Basic Techniques to Open


    Airway
    1. Head tilt
    2. Chin Lift
    3. Jaw Thrust

    Trias
    manouvers

    Triple Airway Manuever

    Airway devices
    1.
    2.
    3.
    4.
    5.
    6.

    Oropharyngeal Airway (OPA)


    Nasopharyngeal Airway (NPA)
    Laryngeal Mask Airway (LMA)
    Multilumen Esophageal Airway
    Laryngeal Tube Airway (LTA)
    Gum Elastic Tube / ETTI

    Oropharyngeal Airway

    Technique
    Clear the mouth
    and pharynx
    Place the airway so
    that it is turned
    backward as it
    enters the mouth
    As airway
    approaches the
    posterior wall of
    the pharynx
    rotate 180 degrees

    Contraindications to Oropharyngeal Airways

    Inability to tolerate (gagging,


    vomiting)
    Airway swelling (burns, toxic gases,
    infection)
    Bleeding into the upper airway
    Absence of pharyngeal or laryngeal
    reflexes
    Impaired mouth opening (e.g., with
    trismus or temporomandibular joint

    Nasopharyngeal Airway

    Technique
    Airway is
    lubricated with
    anesthetic jelly
    Resistance
    slight rotation of
    the tube

    Contraindications to Nasopharyngeal Airways

    Narrow nasal airway in young children


    Blocked or narrow nasal passages in adults
    Airway swelling (burns, toxic gases, infection)
    Bleeding into the upper airway
    Absence of pharyngeal or laryngeal reflexes
    Fractures of the mid-face or base of skull
    Clinical scenarios in which nasal hemorrhage
    would be disastrous

    Laryngeal Mask Airway


    (LMA)

    Airway adjunct with a cuffed mask-like projection


    at the distal end that is introduced to the pharynx

    LMA Introduced Through Mouth Into


    Pharynx

    Tracheal Intubation
    Keeps Airway patent
    Ensures delivery of high concentration of
    oxygen
    Ensures delivery of a selected tidal
    volume
    Isolates and protects the airway from
    aspiration of stomach contents
    Permits effective suctioning
    Provides route for administration of
    several medications (Adrenaline, Sulfas
    atropine)

    Indications
    Cardiac arrest with ongoing chest
    compressions
    Inability of conscious patient in
    respiratory compromise to breathe
    adequately
    Inability of the patient to protect
    airway
    Inability of the rescuer to ventilate
    the unresponsive patient with
    conventional methods

    Complications
    Traumateeth, lips, tongue,
    mucosa,
    vocal cords, trachea
    Esophageal intubation
    Vomiting and aspiration
    Hypertension and arrhythmias

    Equipment for Intubation


    Laryngoscope with
    several blades
    Tracheal tubes
    Malleable stylet
    10-mL syringe
    Magill forceps
    Water-soluble lubricant
    Suction unit, catheters,
    and tubing

    Curved vs Straight Blade

    Macintosh

    Miller

    Curved vs Straight Blade

    Visualization of Vocal Cords


    Tongue
    Vallecula
    Epiglottis
    Glottic
    opening

    Vocal
    cord

    Arytenoid
    cartilage

    Difficult Intubation

    L =
    E =
    M=
    O=
    N=

    Look Externally
    Evaluate the 3-3-2 Rule
    Mallampati
    Obstruction
    Neck Mobility

    Cricothyrotomy

    Tracheostomy
    Indications for Tracheostomy
    Inability to maintain a patent
    airway
    Suspected cervical spine
    instability (percutaneous
    technique only)
    Prevention of damage to vocal
    cords and (possibly) subglottic
    stenosis
    Abnormal anatomy
    (percutaneous only)
    Upper airway obstruction
    High inotrope or ventilatory
    requirement (relative)
    Requirement for
    tracheobronchial toilet with
    suctioning
    Part of larger surgical
    procedure (e.g., laryngectomy)

    Contraindications to
    Tracheostomy
    Prolonged orotracheal
    or nasotracheal
    intubation
    Local inflammation
    Failure to wean from
    ventilation
    Bleeding disorder
    (relative)
    Absence of protective
    airway reflexes
    Arterial bleeding in
    neck/upper thorax

    Benefits
    Comfort
    Reduced need for sedation
    Improved weaning from
    ventilation
    Improved ability to suction
    trachea
    Prevention of ulceration of
    lips and tongue or healing
    of such ulcers
    Reduced upper airway
    injury
    Potential for speech and
    oral nutrition

    Complications
    Misplacement of tube
    Primary hemorrhage
    Pneumothorax or
    tension pneumothorax;
    hemothorax
    Surgical emphysema
    Infection
    Late hemorrhage
    erosion of innominate
    (or other) vessels
    Tracheoesophageal
    fistula

    Esophageal-Tracheal
    Combitube
    E
    Distal End
    A
    C

    A = esophageal obturator; ventilation into trachea through


    side openings = B
    C = tracheal tube; ventilation through open end if proximal
    end inserted in trachea
    D = pharyngeal cuff; inflated through catheter = E
    F = esophageal cuff; inflated through catheter = G
    H = teeth marker; blindly insert Combitube until marker is at
    level of teeth

    Proximal End

    H
    D

    Esophageal-Tracheal
    Combitube

    Providing Ventilatory
    Support

    Mouth to Mouth / Nose


    Mouth to Mask
    Bag Mask
    Independent Lung Ventilation (ILV)
    Positive End-Expiratory Pressure
    (PEEP)
    Continuous Positive Airway Pressure
    (CPAP)

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