Airway Management

1. Airway Management

2. Lesson 15: Airway Management You Are the Emergency Medical Responder 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 patient’s chest does not rise when you attempt ventilations.

3. Suctioning • Process of removing foreign matter, such as mucus, fluid or blood, from a patient’s upper airway • Two types of devices • Use of sterile suction catheters of appropriate size • Mechanical: electrically • powered • Manual: hand powered; • no energy source

4. SuctioningClear Victim’s Airway • Steps for Suctioning • Turn head to side or roll body if head, neck, or back injury suspected • Open victim’s 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 • Victim’s earlobe to corner of mouth • Open victim’s 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 victim’s 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 mother’s call for help.

13. You Are the Emergency Medical Responder You reposition the patient’s airway and attempt 2 ventilations, but the chest still does not rise. After a few minutes of care, the patient’s chest begins to rise and fall with the ventilations, but he is not breathing on his own.