7: Airway

1. 7: Airway

2. Anatomy Review

3. Breathing Process: Inhalation • Active part of breathing • Diaphragm and intercostal muscles contract, allowing the lungs to expand. • The decrease in pressure allows lungs to fill with air. • Air travels to the alveoli where exchange of gases occurs.

4. Breathing Process: Exhalation • Does not normally require muscular effort • Diaphragm and intercostal muscles relax. • The thorax decreases in size, and ribs and muscles assume their normal positions. • The increase in pressure forces air out.

5. The Body’s Need for Oxygen

6. Gas Exchange • Inhalation delivers oxygen-rich air to alveoli. • Oxygen diffuses into the blood. • Breathing is primarily adjusted by the level of carbon dioxide in the blood.

7. Hypoxia • Not enough oxygen for metabolic needs • Develops when patient is: • Breathing inadequately • Not breathing

8. Signs of Hypoxia • Nervousness, irritability, and fear • Tachycardia • Mental status changes • Use of accessory muscles for breathing • Difficulty breathing, possible chest pain

9. Conditions Resulting in Hypoxia • Chest injury • Shock • Lung disease • Asthma • Premature birth • Myocardial infarction • Pulmonary edema • Acute narcotic overdose • Smoke inhalation • Stroke

10. Recognizing Adequate Breathing • Normal rate and depth • Regular pattern • Regular and equal chest rise and fall • Adequate depth

11. Normal Respiration Rates • Adults 12 to 20 breaths/min • Children 15 to 30 breaths/min • Infants 25 to 50 breaths/min

12. Recognizing Inadequate Breathing • Fast or slow rate • Irregular rhythm • Abnormal lung sounds • Reduced tidal volumes • Use of accessory muscles • Cool, damp, pale or cyanotic skin

13. Head Tilt–Chin Lift • Kneel beside patient’s head. • Place one hand on forehead. • Apply backward pressure. • Place tips of finger under lower jaw. • Lift chin. Head tilt-chin lift

14. Jaw-Thrust Maneuver • Kneel above patient’s head. • Place fingers behind angle of jaw. • Use thumbs to keep mouth open.

15. Assessment of the Airway • Look. • Listen. • Feel.

16. Basic Airway Adjuncts (1 of 6) • Oropharyngeal airways • Keep the tongue from blocking the upper airway • Allow for easier suctioning of the airway • Used in conjunction with BVM device • Used on unconscious patients without a gag reflex

17. Basic Airway Adjuncts (2 of 6) Inserting an oropharyngeal airway 1. Select the proper size airway. 2. Open the patient’s mouth. 3. Hold the airway upside down and insert it in the patient’s mouth. 4. Rotate the airway 180° until the flange rests on the patient’s lips.