Presentation is loading. Please wait.

Presentation is loading. Please wait.

Alternative airway devices

Similar presentations

Presentation on theme: "Alternative airway devices"— Presentation transcript:

1 Alternative airway devices
Dr Sadia Farhan

2 Multilumen Airways Inserted blindly
Proven to secure airway and allow for better ventilation. Two devices: Pharyngotracheal lumen airway Combitube

3 Multilumen Airways Combitube Long tube
Can be used for ventilation whether it is inserted into the esophagus or trachea

4 Multilumen Airways Indications Contraindications
Unresponsive, apneic patients with no gag reflex in whom intubation is not possible Cannot be used in children younger than 16 years Only use for patients between 5 ft and 7 ft tall. Contraindications Esophageal trauma Known pathologic condition of the esophagus Ingestion of a caustic substance

5 Multilumen Airways Disadvantages Advantages
Wrong port results in no pulmonary ventilation Risk of aspiration Intubating the trachea via direct laryngoscopy is challenging. Advantages Ventilation in esophagus or trachea Insertion is easier than ET intubation Minimal cervical spine movement No mask seal Airway patency

6 Complications of Multilumen Airways
Unrecognized displacement into esophagus Laryngospasm, vomiting, hypoventilation Pharyngeal or esophageal trauma Ventilation may be difficult if the pharyngeal balloon pushes the epiglottis over the glottic opening.

7 Insertion Techniques Combitube consists of:
Single tube with two lumens Two balloons Two ventilation attachments Before insertion, prepare equipment.

8 Insertion Techniques Head should be in a neutral position
Insert thumb into the mouth and lift the jaw. Insert device until incisors are between the two black lines Two valves must be inflated sequentially.

9 Insertion Techniques After inflation of balloons, begin to ventilate
Through the longer (blue) tube first Observe for chest rise and auscultate. If there are no breath sounds, switch to the shorter (clear) tube. Continuously monitor ventilation.

10 Laryngeal Mask Airway (LMA)
Option for patients who: Require more support than bag-mask Do not require ET intubation Conduit from glottic opening to ventilation device

11 Laryngeal Mask Airway (LMA)
Surrounds larynx opening with an inflatable cuff Cuff conforms to airway contours, forms airtight seal

12 Laryngeal Mask Airway (LMA)
Indications and contraindications Alternative to bag-mask ventilation Less effective in obese patients Pregnant patients and patients with a hiatal hernia are at risk for regurgitation. Ineffective with patients requiring high pulmonary pressures

13 Laryngeal Mask Airway (LMA)
Advantages Better ventilation No continual maintenance of a mask seal No laryngoscopy Less risk of trauma Protection from secretions Disadvantages No protection against aspiration Air may be insufflated into the stomach

14 Complications of Using LMA
Involve regurgitation and aspiration Weigh against risk of hypoventilation Hypoventilation of patients who require high ventilatory pressures can occur. Upper airway swelling has been reported.

15 Equipment for LMA Seven sizes; based on the patient weight
Consists of tube and inflatable mask cuff Two bars at opening prevent occlusion Proximal end is fitted with standard adapter

16 Equipment for LMA Cuff has a one-way valve assembly
6.0-mm ET tube can be passed through size 3 or 4 LMA

17 King LT Airway Latex-free, single- use, single-lumen
Positive-pressure ventilation for apneic patients Maintains airway in spontaneously breathing patients who need advanced management .

18 King LT Airway Curved tube with ventilation ports between two inflatable cuffs Can be inserted more easily than the Combitube

19 King LT Airway Two types: King LT-D: used for adults and children
King LTS-D: used for adults Five sizes of each type

20 King LT Airway King LT-D and LTS-D share many features:
Proximal pharyngeal cuff, distal cuff, ventilation outlets ET tube introducer can be inserted through the tube Distal end: closed in LT-D; open in LTS-D

21 King LT Airway Indications Contraindications
Alternative to bag-mask ventilation Same considerations as Combitube Contraindications Patients with an intact gag reflex Patients with known esophageal disease Patients who have ingested a caustic substance

22 Complications of the King LT Airway
Laryngospasm, vomiting, hypoventilation Trauma from improper insertion technique Pharyngeal balloon may push the epiglottis over the glottic opening May make ventilation difficult

23 Insertion Technique Patient’s height and weight determine size you should use.

24 Cobra Perilaryngeal Airway (CobraPLA)
Shape lets device: Slide easily along the hard palate Hold airway’s soft tissue away from the laryngeal inlet Available in eight sizes

25 Cobra Perilaryngeal Airway (CobraPLA)
Indications Usage similar to other supraglottic airway devices Can be used in pediatric patients Does not protect against aspiration Contraindications Risk for aspiration Risk for massive trauma to oral cavity

26 Contraindications and Complications
Laryngospasm may occur with intact gag reflex Cuff inflation may cause tongue to disrupt seal. Patient cannot be ventilated if device is too small.

Download ppt "Alternative airway devices"

Similar presentations

Ads by Google