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

TECHNIQUES FOR OPENING THE AIRWAY

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?