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Upper Airway management

Upper Airway management. Dr Kapila Hettiarachchi. Triple Maneuver. Chin Lift Jaw Thrust Head tilt. Chin lift & head tilt. Chin lift & head tilt. Chin lift & head tilt. Jaw thrust. Jaw thrust. Jaw thrust. Jaw thrust. O ptions to manage the airway. Simple airway adjuncts

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Upper Airway management

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  1. Upper Airway management Dr Kapila Hettiarachchi

  2. Triple Maneuver • Chin Lift • Jaw Thrust • Head tilt

  3. Chin lift & head tilt

  4. Chin lift & head tilt

  5. Chin lift & head tilt

  6. Jaw thrust

  7. Jaw thrust

  8. Jaw thrust

  9. Jaw thrust

  10. Options to manage the airway Simple airway adjuncts • Oropharyngeal airway • Nasopharyngeal airways Laryngeal Mask Airway (LMA) ET tube

  11. Simple airway adjuncts

  12. Rusch Color Coded Guedel Airways

  13. Guedel pattern airway

  14. Guedel pattern airway

  15. Airway obstruction

  16. Sizing an oropharyngeal airway

  17. Oropharyngeal airway insertion

  18. Ventilation BVM (Bag-valve-mask)

  19. The mostimportantairwayskill

  20. Mask Ventilation Always the first response to inadequate oxygenation and ventilation The first “bail-out” maneuver to a failed intubation attempt Delay the urgency to intubate

  21. BVM Ventilation Requires practice to master One hand to • Maintain face seal • Position head • Maintain patency Other hand ventilates

  22. Bag-valve-mask, 2-person ventilation

  23. Sniffing the morning air!!

  24. Sniffing Position • Align oral, • pharyngeal, • and laryngeal axes to • bring epiglottis and • vocal cords into view

  25. BVM Ventilation: Assessment of Efficacy How do I know I am ventilating? • Observe the chest rise and fall • Good bilateral air entry • Lack of air entering the stomach • Feeling the bag • ETco2 • Pulse oximetry

  26. Laryngeal Mask Airway

  27. LMA Insertion

  28. Laryngeal Mask Airway

  29. LMA Sizing

  30. Advantages of Using LMA Leaves provider’s hands free Patient can produce effective cough Allows spontaneous ventilation Malposition even can adequately ventilate Sore Throat- less than ETT Better tolerated than ETT Better than Face Mask Minimal Cardiovascular Response

  31. Disadvantages of LMA over ETT Lower seal pressure Higher frequency of gastric insufflation Increased Aspiration risk

  32. Endotracheal intubation

  33. Equipment Laryngoscope Tubes Oxygen source Bag & Mask Suction Lubricant Forceps (Magill) Adhesive tape Stylet Syringe

  34. Stainless Laryngoscope Blades

  35. Tracheal Tube

  36. ETT : sizes (Pediartics)

  37. Anticipate the difficulties • Identify in advancethe patient with anatomical difficulty • Have sufficient skill and training • Have apreformulatedplan for potential disaster

  38. What do we do when we have a difficult airway ?

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