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
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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?