Emergency Department

Airway Management

Upper-Airway Anatomy: Nose Mouth Nasopharynx Oropharynx Larynx Trachea

Airway Maneuvers: (Primary Airway Management) Head Tilt-Chin Lift Jaw Thrust

Head tilt-Chin Lift:

Jaw Thrust:

Airway Devices: (Secondary Airway Management) Oropharyngeal Airway Nasopharyngeal Airway Bag-Mask Ventilation Laryngeal Mask airway(LMA) Esophageal-Tracheal Combitube Orotracheal Intubation

Oropharyngeal Airway: Choose The Best One Do Not Use It In CONSCIOUS Patients.

Technique: A.Insertion B.Rotation (180 )

Nasopharyngeal airway: Choose The Best One Do Not Use It In Skull Bass Fx. Patients.

Bag-Mask V.

Use your third, fourth, and fifth fingers to lift the mandible up into the mask. It may be possible to place the fifth finger behind the mandible and perform a jaw thrust.

The traditional technique is the “double C-E” method The traditional technique is the “double C-E” method. Use the thumb and index fingers of both hands to encircle the top of the mask.

Use the third, fourth, and fifth fingers of each hand to lift both sides of the mandible to meet the mask. It is difficult to do a good jaw lift with this method.

Laryngeal Mask Airway (LMA): Choose The Best One

Figure 3-9 Intubating laryngeal mask airway (ILMA or “Fastrach”) insertion Completely deflate the cuff while pushing it posteriorly, so that it assumes a smooth wedge shape without any wrinkles.

Place a small amount of water-based lubricant onto the posterior surface of the ILMA just before insertion.

Place the head and neck in a slightly elevated position with minimal extension. Open the mouth widely and place the posterior surface of the device against the hard palate, immediately posterior to the upper incisors.

Advance the ILMA straight into mouth until the curved part of the airway tube contacts the chin. Then, rotate the ILMA into the hypopharynx until firm resistance is felt. Release cricoid pressure during this step.A

Next, lift the handle upwards, toward the ceiling above the patient’s feet. This manuever aligns the mask with the glottis and may provide for better ventilation.

If these manuevers fail, the epiglottis may be folded down over the glottis (asterisk). Perform the “up-down” manuever, by first rotating the ILMA out of the hypopharynx along its curvature about 5–6 cm.

Next, slide the ILMA back into position while pressing it against the posterior pharynx. (Note, the cuff should remain inflated during this maneuver.)

Esophageal Tracheal Combitube:

Esophageal Tracheal Combitube:

Orotracheal Intubation: Indications: 1.Hypoxemia 2.Hypoventilation 3.Muscle Fatigue 4.Airway Protection 5.Threatened Airway 6.Out Of ED Facilities

Prepare Laryngoscope: Laryngoscope Should Be In Your LEFT Hand

Prepare Patient: A-B-C Extend-the-head-on-neck (“look up”): aligns axis A relative to B Flex-the-neck-on-shoulders (“look down”): aligns axis B relative to C

How To Intubate? 1. Insert The Laryngoscope In RIGHT Side Of Mouth. 2. When You See The Epiglottis Push It UP & FORWARD. 3. Now ,You Can See The Vocal Cords. Easy To Say Difficult To Do

True Intubation:

Vocal Cords To Mouth:

Intubation By Glidoscope: Difficult Intubation Intubation Training

And Now A Surgical Method For Airway Management Cricothyroidotomy In 20 Sec.

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