04 Airway Management

Download as ppt, pdf, or txt
Download as ppt, pdf, or txt
You are on page 1of 32

Advanced Life Support

AIRWAY MANAGEMENT AND VENTILATION


se R nae po u E r

2/15/2003 , 1

Advanced Life Support

Airway management & ventilation Objective

se R nae po u E r

Basic airway management and ventilation The laryngeal mask airway and Combitube Advanced techniques of airway management

Advanced Life Support Common causes of airway obstruction Upper Airway tongue soft tissue oedema, foreign material blood, vomit Larynx laryngospasm, foreign material Lower Airway secretions, oedema, blood bronchospasm aspiration of gastric contents

se R nae po u E r
3

Advanced Life Support Recognition of airway obstruction LOOK for chest/abdominal movement LISTEN at mouth and nose for breath sounds, snoring, gurgling
se R nae po u E r

FEEL

at mouth and nose for expired air

Advanced Life Support Opening the airway

Head tilt Chin lift Jaw thrust


se R nae po u E r

CAUTION! cervical spine injury

Advanced Life Support Head Tilt and Chin Lift

se R nae po u E r
6

Advanced Life Support Jaw Thrust

se R nae po u E r
7

Advanced Life Support Suction

se R nae po u E r
8

Advanced Life Support

Simple airway adjuncts


se R nae po u E r

Advanced Life Support Oropharyngeal Airway

se R nae po u E r

Advanced Life Support Nasopharyngeal Airway

se R nae po u E r

Advanced Life Support Mouth to mask ventilation


Advantages: Avoids direct person to person contact Decreases potential for cross infection Allows oxygen enrichment
se R nae po u E r

12

Limitations: Maintenance of airtight seal Gastric inflation

Advanced Life Support Bag-valve-mask, 2-person ventilation

se R nae po u E r

13

Advanced Life Support Ventilation using self inflating bag

se R nae po u E r

Advantages Avoids direct person to person contact Allows oxygen supplementation up to 85% Can be used with facemask, LMA, Combitube, tracheal tube

Advanced Life Support Ventilation using self inflating bag

se R nae po u E r

Limitations When used with a facemask: Risk of inadequate ventilation Risk of gastric inflation Need two persons for optimal use

15

Advanced Life Support

Advanced Airway Management


se R nae po u E r

Advanced Life Support The Laryngeal Mask Airway

se R nae po u E r

Advanced Life Support The Laryngeal Mask Airway


se R nae po u E r

Advantages Rapidly and easily inserted Variety of sizes More efficient ventilation than facemask Avoids the need for laryngoscopy

18

Advanced Life Support The Laryngeal Mask Airway

se R nae po u E r

Limitations No absolute guarantee against aspiration Not suitable if very high inflation pressures needed Unable to aspirate airway

Advanced Life Support The Laryngeal Mask Airway


Fig 1

Fig 2
se R nae po u E r

Fig 3

Advanced Life Support The Laryngeal Mask Airway

se R nae po u E r

Advanced Life Support

The Combitube

se R nae po u E r

Advanced Life Support The Combitube

se R nae po u E r

Advanced Life Support The Combitube


se R nae po u E r

Advantages Rapidly and easily inserted Avoids need for laryngoscopy Protects against aspiration Can be used if inflation pressures high

24

Advanced Life Support The Combitube

se R nae po u E r

Limitations Available in 2 sizes only Potential for ventilation via wrong lumen Damage to cuffs on insertion Trauma on insertion Single use

Advanced Life Support The Combitube

se R nae po u E r

Advanced Life Support

Tracheal Intubation

se R nae po u E r

Advanced Life Support Tracheal Intubation

Advantages Allows ventilation with up to 100% O2 Isolates airway, preventing aspiration Allows aspiration of the airway Alternative route for drug administration

se R nae po u E r

28

Advanced Life Support Tracheal Intubation

se R nae po u E r

Limitations Training and experience essential Failed insertion, oesophageal placement Potential to worsen cervical cord or head injury

Advanced Life Support Needle Cricothyroidotomy


Indication Failure to provide an airway by any other means Complications Malposition of cannula Emphysema Haemorrhage Oesophageal perforation Hypoventilation Barotrauma

se R nae po u E r

30

Advanced Life Support

Any Questions?
se R nae po u E r

31

Advanced Life Support Summary

se R nae po u E r

Recognise and relieve airway obstruction using basic techniques Oxygen The role of the LMA, Combitube and tracheal intubation in managing the airway during CPR

32

You might also like