4 Intubation kit Laryngoscope ET Stylet Syringe 10ml Suction catheter Carbon dioxide detectorOral & nasal airwaysAmbu bag & mask attached to oxygen source
5 Rapid sequence intubation Endotracheal intubation using RSI is the cornerstone of emergency airway management .RSI: the administration of a potent induction agent followed immediatelyby a rapidly neuromuscular blocking agent to induce unconsciousness & motor paralysis for tracheal intubation
11 Difficult airway assessement Look externally : physical features such as a small mandible , large tongue , short bull neck & obesity , facial or mandibular fracture are all red flags for a difficult airway
14 Difficult airway assessement Obstruction : 3 signs of upper airway obstruction are stridor , muffled voice,difficulty swallowing secretions.Neck mobility:cervical spine immobilization in trauma , medical condition such as ankylosing spondylitis or RA.
30 Miscellanous Cricoid pressure:Sellick’s maneuver External Laryngeal Manipulation or BURP Backward Upward Right Pressure maneuverELM improved the laryngoscopic view by one whole grade in most pts initially rated 2 or 3All pts presenting grade 3 view were converted to grade 1 or 2 with ELM
31 Summary Always be prepared for a difficult airway. No single airway assessment tool is sufficiently sensitive nor specific to reliably predict or rule out a difficult airway.In many cases features of the patient’s morphology & pathology enable prediction of a difficult airway