Presentation on theme: "Sydney Clinical Skills and Simulation Centre Management of the Critically Obstructed Airway Session 2: Supraglottic Airway Rescue and Transition to Infraglottic."— Presentation transcript:
Sydney Clinical Skills and Simulation Centre Management of the Critically Obstructed Airway Session 2: Supraglottic Airway Rescue and Transition to Infraglottic Airway Rescue (Acknowledgements: adapted from talks by Dr Jamie Beit, Toowoomba), Helen Zois (Sydney) and Adam Rehak (Sydney)
CICO Plan Part 1 Supraglottic Airway Rescue Part 1 Supraglottic Airway Rescue Part 2 Transition to CICO Part 2 Transition to CICO Part 3 Infraglottic Airway Rescue Part 3 Infraglottic Airway Rescue
Best attempt face-mask ventilation Optimal position (ear > sternum) Head tilt chin lift jaw thrust 2 handed BMV Second person ventilates High fresh gas flows (O 2 flush) Oro/Nasopharyngeal airway Cricoid off
Best attempt endotracheal intubation Best person in room Best position (tragus >sternum) Best blade (e.g., videolaryngoscope) External laryngeal Manipulation (ELM) Bougie or stylet (only1 blind attempt) Consider muscle relaxant (if experienced) Cricoid off
Best attempt LMA ventilation Different type (e.g. Proseal™) Different size Insert under direct vision) Insertion with jaw thrust Pull tongue forward Cricoid off Consider muscle relaxant (if experienced)
There is no ideal number of attempts for face mask ventilation, endotracheal intubation or LMA ventilation. A best attempt: may involve >1 attempt is unlikely to be beneficial with >3 attempts How many attempts?
Best attempt at: Face-mask ventilation? LMA ventilation? Endotracheal intubation? AND Oxygen saturations falling or persistently low? Is this a CICO situation? INFRAGLOTTIC RESCUE YES Continue Supraglottic rescue Consider waking patient Review again in 1 min Continue Supraglottic rescue Consider waking patient Review again in 1 min With permission A. Heard and Working group for the Rural Health Continuing Education (RHCE) (Stream 1) ‘Critically Obstructed Airway Workshop’. Contact firstname.lastname@example.org. email@example.com NO TRANSITION ‘Transition’ protocol - CICO MOBILISE RESOURCES FOR CICO