Simple MANOEUVRES save lives Airway management BASICS Education March 2019 Open Airway Cspine and O 2 NPA OPA Supraglotal airway Surgical Airway Objectives the airway ladder ID: 781185
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Slide1
If you do not manage the patient’s airway – they will dieSimple MANOEUVRES save lives
Airway management
© BASICS
Education
March 2019
Slide2Open Airway, C-spine and O
2
NPA
OPA
Supraglotal airway
Surgical Airway
Objectives: the airway ladder
Suction
MASTER
Endotracheal intubation
Slide3Airway careAirway obstruction killsHypoxia killsBe aware of cervical spine injury potential
Slide4Airway assessmentLOOK for chest and abdominal movementLISTEN for breathing and abnormal sounds
FEEL for expired air and chest movement
Slide5Noisy breathingCrowing - laryngeal spasmGurgling - liquids in airway
Snoring - partial obstructionA completely obstructed airways makes no noise
Slide6OxygenFirst drug of emergency care10 to 15 lpm flow
Reservoir maskNon - rebreathing mask with reservoir bagProviding respiratory support: Pocket mask & O2BVM with reservoirBTS guidelines
Slide7Basic opening manoeuversHead tilt / chin liftJaw thrust
These manoeuvres lift the tongue off the pharynx and align the axis of the mouth and larynx
Slide8Suction
Slide9Nasopharyngeal Airways
Under used & valuable airway management
tool
Prevents the soft palate abutting the pharynx
Size 6.0 Female 7.0 Male Careful use in suspected basal skull fracture
Slide10Airway Adjuncts
Oropharyngeal airway (OPA)
Requires sizing
Centre
of teeth to angle of
jawCorner of mouth to tragus of ear
Slide11Problems of airway adjunctsLaryngeal spasmLocal traumaRaised intracranial pressureVomiting
Slide12Bag-Valve-MasksAlways use with a reservoir bag & O2Difficult to maintain a seal
two person techniqueBagging rate often too highSqueezing the bag is not the same as ventilationalways look for chest rise Leaks can result in hypoventilationExcessive effort inflates the stomach
Slide13Supraglottic airway – I-Gel / LMABlind technique, simple to learnHighly suitable for pre-hospital use
Better skill retention than ETT Avoids many problems of face masksRelatively secure airwayCan leak if seal broken on movingSizing By weight3 Small adult4 Female5 Male
Slide14Progressing up the airway ladderDo not move from A to B until A is managed
If an airway method fails: Revert to last successful methodReoxygenateReassess optionsHeading towards extremis – consider:Surgical crichothyroidotomy
Slide15Pharmacology and airway controlThe routine use of Benzodiazepines to assist airway control is not recommendedRSI is an appropriate method of takingcontrol of the airway for those who are
qualified and experienced in its use inThe pre-hospital setting Pre-hospital AnaesthesiaAssoc of anaesthetists of Great Britain & IrelandNov 2008
Slide16Airway managementQuestions?
Slide17SUMMARYHypoxia killsA always comes before BIntervene with appropriate adjuncts
Use an airway ladder approachStay within your competence & experience
Slide18Carnival UK
Immediate Care Course