Airway 101 UCSF-Fresno June 19, 2015.

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Presentation transcript:

Airway 101 UCSF-Fresno June 19, 2015

Objectives Understand the LEMON Law and why it is an important predictor of airways Practice bagging and intubation Practice utilizing airway adjuncts Recognize a difficult airway

Approach to the Airway Is this airway going to be difficult? What tools do I need? What is my blade of choice? What is my backup plan?

Ideal conditions for intubation Ideal Lighting, positioning, etc. Plenty of assistance Time to prepare, plan, discuss Option to Abort Empty Stomach Back up available

Adult – Normal Cords

LEMON Law – predictor of difficult intubations L - Look Externally: buck teeth, small jaw, external trauma E - Evaluate Internally: 3-3-2 M - Mallampati Score: open mouth and stick out the tongue w/o saying “Aaahh” O - Obstruction: large tongue, neck tumors, previous trach N - Neck Mobility: chin to chest, neck range of motion

Look Externally – Is this going to be a difficult or easy airway?

Look Externally – Is this going to be a difficult or easy airway?

Look Externally – Are these going to be a difficult or easy airways?

Evaluate 3-3-2

Mallampati Score

Mallampati Class I & II

Mallampati Class III & IV Uh Oh!

Look for OBSTRUCTION – Is this going to be a difficult or easy airway?

Neck Mobility – Is this going to be a difficult or easy airway?

Neck Mobility– Is this going to be a difficult or easy airway?

Can’t Intubate, Can’t Ventilate Occurs 1:10,000 patients BVM Failure? You haven’t failed with the BVM until 2 nasal airways & an oropharyngeal airway are in place

NEXT…….. Break up into 2 groups of 5 people 15 minutes at each station

Station 2: Bagging & Airway Adjuncts Objectives: 1. List equipment needed for BLS airway management 2. Master one and two person bagging techniques 3. Practice using airway adjuncts 4. Review intubation roll

Station 3: Intubation Objectives: 1. List the equipment needed for intubation 2. Describe the difference between a Mac and Miller Blade 3. Practice mechanics of intubation 4. List tools to recognize proper ETT placement