BASIC AIRWAY MANAGEMENT. Basic Airway Objectives. Upon completion the student will be able to: Describe the anatomy of the airway and the physiology of respiration. Explain the primary objective of airway maintenance Identify commonly neglected prehospital skills related to the airway
Upon completion the student will be able to:
Oxygen is the most important drug that we
can give a patient. Without it, the body’s cells
die and thus the patient dies also.
* “D” 350 L
* “E” 600 L
* “M” 3,000 L
Pin Index Safety System (PISS)
1. Demand Valve
* Activated manually or by negative
2. Flow Meter (Two Types)
* Small ball in a calibrated tube; affected
by gravity, measures actual delivered
flow; found in Units mounted on wall.
* Not affected by gravity; records a higher
reading when an obstruction blocks
tubing; used on portable O2 tanks
15 w/o reservoir 50%
15 w/reservoir up to 95%
Opens most common cause of obstruction, the
1. Tongue/jaw lift
2. Modified jaw thrust
Even when in place, it is necessary to
maintain manual positioning of the airway by
a head-tilt, chin-lift or jaw-thrust maneuver.
1. Using a tongue blade. Preferred method in
2. Insert upside down and rotate into place.
Not to be used in children.
1. To Long: may push the epiglottis closed
over the glottic opening, causing complete
2. To Short: May be easily displaced, distal opening may become obstructed by tongue
A curved hollow tube constructed of soft
plastic or rubber with a bevel at the distal end
and a flange or flare at the proximal end.
This airway is less likely to stimulate gagging
and vomiting because the the pliable tube
moves and flexes as the patient swallows.
It may be used in a patient who is breathing
but needs assistance in maintaining a patent
15cm in length.
The distal tip sits at the posterior pharynx
while the proximal flare is seated on the
1. When OP is not able to be inserted
2. Airway of choice in spontaneously breathing, but less responsive patient needing airway control.
1. Proximal end of the tube at the tip of the nose and the distal end at the earlobe
* Needs to be lubricated.
* Proper size
* Advance with bevel toward the septum
* If patient is breathing you should feel
airflow when placed properly.
* If you meet resistance, remove and use
* Improper size and too long could end up
in the esophagus
* Too short could be occluded by the
Stimulation of vomiting
Aspiration of gastric contents during insertion
Soft tissue damage from cuff pressure
Inadequate mask seal
Unrecognized tracheal intubation
Do not leave in place for longer than 2 hours
Have suction available when removing
Remove when patient resumes breathingEOA/COMPLICATIONS
Prevents air from entering the stomach
Prevents vomitus from traveling up the esophagus
ET may still be inserted with EOA in place
Head and neck of a C-Spine Injury may be maintained in a neutral in-line position during its insertionEOA/ADVANTAGES
May cause trauma to the esophagus or airway
Can be easily misplaced in the trachea
Cannot be left in place for prolonged periods of time
Does not isolate the trachea and prevent aspiration of contents from the upper airway
Tracheobronchial suctioning cannot be performed.EOA/DISADVANTAGES
Insert the tube (with mask attached) blindly into the mouth and throat
Pass the tube gently until the mask seats on the patients face
* Do not inflate the cuff until proper placements is confirmed
* Auscultate 4 lung fields and the epigastric regionEOA/INSERTION
* If accidentally placed in the trachea and the cuff is inflated before checking for proper placement, serious damage to the trachea can result (30-35 cc’s of air)
* Patient regains gag reflex, position patient on side
* Stand by with “crash” suction
* Remove the mask
* Deflate the cuffEOA/INSERTION
Use only sterile devices
Lubricate all suction catheters and tips
Maximum of 10 seconds of suction time
Suction on withdrawal of catheter, rotating slowly (ET)SUCTIONINGGENERAL RULES