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AIRWAY MANAGEMENT

AIRWAY MANAGEMENT. Respiratory Problems are the most common cause of Pediatric Arrest. Wanida Paoin Thammasat Hospital,Thammasat University. AIRWAY MANAGEMENT. Airway positioning, opening oro/nasopharyngeal airway Breathing mouth to mouth ( + nose) bag-mask laryngeal mask

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AIRWAY MANAGEMENT

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  1. AIRWAY MANAGEMENT

  2. Respiratory Problemsare the most common cause ofPediatric Arrest Wanida Paoin Thammasat Hospital,Thammasat University

  3. AIRWAY MANAGEMENT Airway positioning, opening oro/nasopharyngeal airway Breathing mouth to mouth (+ nose) bag-mask laryngeal mask endotracheal intubation

  4. C7 Airway Anatomy & Physiology ทำไมเด็กจึงหายใจทางจมูกได้ดีกว่าทางปาก ทำไมจึงต้องใช้ straight blade ในการใส่ ET tube ในเด็กอายุน้อยกว่า 2 ปี ทำไมจึงสามารถใส่ ET tube ในเด็กทารกได้ง่ายขณะเด็กตื่น ทำไมจึงเลือกใช้ uncuff-tube ในเด็กอายุน้อยกว่า 8 ปี ทำไม ET tube ในเด็กทารกจึงเลื่อนหลุดได้ง่าย Narrower nares Large tongue High glottis C4 Slanting vocal cord Immature laryngeal reflex Large occiput Narrow cricoid ring

  5. Airway Anatomy & Physiology Loose tissue

  6. Airway Anatomy & Physiology

  7. Airway • Position • Open the airway • head tilt-chin lift maneuver • jaw-thrust maneuver • oropharyngeal and nasopharyngeal airway • foreign-body airway obstruction

  8. jaw-thrust head tilt-chin lift

  9. Indication Oropharyngeal Airway Nasopharyngeal Airway

  10. Breathing • Assessment • Provide rescue breathing • mouth-to-mouth-and-nose and mouth-to mouth • bag-mask ventilation • laryngeal mask airway • endotracheal intubation • ventilation through a tracheostomy or stoma

  11. self inflating size > 450-500 ml. appropriately sized mask reservoir O2 flow > 10-15 L/min O2 conc. 60-95% opening the airway “E-C clamp visible chest rising avoid excessive ventilation gastric inflation cricoid pressure Bag-mask ventilation

  12. Laryngeal Mask Airway • used in unconscious patient • contraindicted in a patient with an intact gag reflex • eqivalent ventilation compare with ET tube • uncommom aspiration • more difficult to maintain than ET tube

  13. Laryngeal Mask Airway

  14. Endotracheal Intubation 3 tracheal tube: cuff or uncuff suction catheter oxygen source face mask self-inflating bag +PEEP valve stylet lubricant laryngoscope blade and handle exhaled CO2 detector tape and equipment to immobilize • Advantages • Indications • Equipment • Procedure • Verification of proper tube placement

  15. Endotracheal tube size uncuffed tube: tracheal tube size (mm) = age in years + 4 4 cuffed tube: tracheal tube size (mm) = age in years + 3 4

  16. Endotracheal Intubation • Advantages • Indications • Equipment • Procedure • Verification of proper tube placement

  17. Displacemant Obstruction Deteriorating condition of an intubated patient Pneumothorax Equipment failure

  18. AIRWAY MANAGEMENT Airway positioning, opening oro/nasopharyngeal airway Breathing mouth to mouth (+ nose) bag-mask laryngeal mask endotracheal intubation

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