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AIRWAY

Always assess the airway

  • Talk to the patient
       A patient speaking freely and clearly has an open airway
  • Look and listen for signs of obstruction
       Snoring or gurgling
        Stridor or noisy breathing
        Foreign body or vomit in mouth
  • If airway obstructed, open airway and clear obstruction

TECHNIQUES FOR OPENING THE AIRWAY

No trauma

  • Position patient on firm surface
  • Tilt the head
  • Lift the chin to open the airway
  • Remove foreign body if visible
  • Clear secretions
  • Give oxygen 5 L/min
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TECHNIQUES FOR OPENING THE AIRWAY

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In case of trauma

  • Stabilize cervical spine
  • Do not lift head!
  • Open airway using jaw thrust
  • Remove foreign body if visible
  • Clear secretions
  • Give oxygen 5 L/min

AIRWAY DEVICES

Oropharyngeal airway

  • Use if patient unconscious
  • Use correct size - measure from front of ear to corner of mouth
  • Slide airway over tongue
  • If patient resists, gags or vomits, remove immediately!

Nasopharyngeal airway

  • Better tolerated if patient is semi-conscious
  • Pass well lubricated into one nostril
  • Direct posteriorly, towards the throat

AIRWAY

Before attempting intubation the answer to these questions should be YES:

Is there an indication?
-Failure to maintain or protect the airway (risk of aspiration) or
-Failure to oxygenate or ventilate or
-Impending airway failure (inhalation injury, angioedema)

Do you have working equipment?
-Functioning laryngoscope with working light
-Appropriate endotracheal tube size
-Bag-valve mask
-Working oxygen source
-Suction

Do you have a post-intubation plan?
-Is a mechanical ventilator available? (unless only short-term need)
-Are sedative drugs available?

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