Airway Management

1
Airway Management
2
You Are the Emergency Medical Responder
Lesson 15 Airway Management

• As border security in the immediate vicinity and
  trained as an emergency medical responder (EMR),
  you respond to a call at one of the docks for an
  unconscious adult who collapsed for no apparent
  reason. You size-up the scene and notice that a
  middle-age male is lying prone on the floor and
  not moving. You discover that the patients chest
  does not rise when you attempt ventilations.

3
Suctioning

• Process of removing foreign matter, such as
  mucus, fluid or blood, from a patients upper
  airway
• Two types of devices

• Mechanical electrically
• powered
• Manual hand powered
• no energy source

• Use of sterile suction catheters of appropriate
  size

4
SuctioningClear Victims Airway

• Steps for Suctioning
• Turn head to side or roll body if head, neck, or
  back injury suspected
• Open victims mouth
• Sweep large particles of debris out of the mouth
• Measure distance of insertion (earlobe to corner
  of mouth)
• Insert suction device into back of mouth and
  suction on the way out
• No more than -
• Adults 15 sec Child 10 sec Infant 5 sec

5
Airway Adjuncts

• Mechanical airway adjuncts
• Oral (Oropharyngeal)
• airways (OPAs)
• Nasal (Nasopharyngeal) airways (NPAs)
• They keep the tongue (the most common cause of
  airway obstruction) away from the back of the
  throat.
• OPAs are only for unconscious, unresponsive
  patients with no gag reflex

6
Inserting An Oral Airway

• Select airway or proper size
• Victims earlobe to corner of mouth
• Open victims mouth using a crossed finger
  technique
• Insert airway with curved end along roof of mouth
• Advance airway gently until resistance is felt
• Rotate airway ½ turn
• Flange should rest on lips

7
Nasal Airway

• Uses
• Conscious, responsive patient
• Unconscious patient
• Contraindications for use
• Suspected head trauma
• Suspected skull fracture
• Lubrication of airway with water-soluble
  lubricant is necessary
• Insertion with bevel of airway toward septum

8
Inserting a Nasal Airway

• Select airway of proper size
• Measure from victims earlobe to tip of nose
• Lubricate nasal airway
• (K-Y jelly or other water based lubricant)
• Insert nasal airway into right nostril with bevel
  toward MIDDLE of nose
• Advance airway gently, until flange rests on nose

9
Airway Obstructions

• Anatomical obstruction from?
• The tongue
• Swollen tissues of the mouth, tongue or throat
• Mechanical obstruction from?
• Foreign objects, such as food or toys
• Fluids, such as vomit

10
Foreign Body Airway Obstruction (FBAO)

• Universal sign a conscious person who is
  clutching the throat
• Mild or partial FBAO
• Ability to move some air to and from the lungs
• Forcibly coughing, which is encouraged
• Severe FBAO
• Inability to cough, speak, cry or breathe
• Immediate action is necessary

11
Measures to Relieve FBAO

• Conscious patient
• Continued forcible coughing
• Back blows
• Abdominal thrusts (adults and children)
• Chest thrusts (for infants, pregnant women and
  patients too large to reach around)
• Unconscious patient
• Chest compressions
• Finger sweep if object is visible in the mouth

12
Scenario

• While attending a picnic, you notice that a
  4-year-old boy begins coughing very forcibly
  while eating a hot dog. His mother appears
  frantic and begins shouting for help. As a
  trained EMR, you respond to the mothers call for
  help.

13
You Are the Emergency Medical Responder

• You reposition the patients airway and attempt
  2 ventilations, but the chest still does
  not rise.

After a few minutes of care, the patients chest
begins to rise and fall with the ventilations,
but he is not breathing on his own.