Difficult Airway Management 2009 Adrian Sieberhagen.

Slides:

Advertisements

Similar presentations

Airway Management Augusto Torres, MD Department of Anesthesiology

Advertisements

DIFFICULT AIRWAY ASSESSMENT AND MANAGEMENT

RSI Airway Assessment New Hampshire

The Difficult Airway Rafael Ortega, M.D. Associate Professor of Anesthesiology Boston University School of Medicine Recognition, Management, and Prevention.

Emergency Medicine Some Tools for Managing the Difficult Airway Joe Lex, MD, FAAEM Temple University Philadelphia, PA.

Special Airway Devices and Techniques for the Difficult or Failed Airway Pat Melanson,MD.

SVCC Respiratory Care Programs

The Difficult and Failed Airway Principles of Rapid Sequence Intubation Jason Carter, B.S., L.P.

Airway Anatomy Soft palate Hard palate Nasopharynx Oropharynx Hypopharynx Tongue Thyroid cartilage.

Airway obstruction Trauma foreign bodies inflammation hematomas CNS disease secretions Drug overdose Infections glottitis Obstructive sleep apnea.

The Difficult or Failed Airway

THE DIFFICULT AIRWAY.

Dr. Mahmoud Abdel-Khalek

Difficult tracheal intubation

Optional, AEMT. Course Objectives Describe Sellick’s maneuver and the use of cricoid pressure during intubation. Describe the necessary equipment needed.

Alternative airway devices

Basic Airway Management. Review of Important Facts and Concepts: Airway Anatomy Airway Assessment Review basic drugs and equipment setup for managing.

ENDOTRACHEAL INTUBATION Thida Ua-kritdathikarn, MD. Department Of Anesthesiology Faculty of medicine, PSU.

DIFFICULT AIRWAY MANAGEMENT

DIFFICULT AIRWAY MANAGEMENT

Abdullah Alsakka E.M. Consultant. Questions For The Emergency Physician: 1. Can I predict the difficult airway? 2. How often can I expect to be faced.

Airway Management of Patients with a Difficult Airway Orlando Hung Departments of Anesthesia and Surgery, Dalhousie University, Halifax, Nova Scotia Canada.

THE DIFFICULT AIRWAY P. Andrews F08. Stages Of Respiratory Compromise n Respiratory Distress n Respiratory Failure n Respiratory Arrest.

Assessing the Difficult Airway in the ED

SPM 200 Skills Lab 6 Nasogastric Tube (NGT) / Oral and Nasal Airways / O2 Delivery Devices Daryl P. Lofaso, MEd, RRT Clinical Skills Lab Coordinator.

Intubation and Anatomy of the Airway

Difficult Airways Presented by Ri 龔律至 Ri 李又文. Brief history 59 y/o male Oropharyngeal ca.(SCC) s/p CCRT in 2000 Local recurrent oropharyngeal ca. s/p.

Case Evaluation How do you think you did? What do you think you did well? What would you have done differently? How do you think your colleagues did?

PRINCIPLES OF AIRWAY ASSESSMENT

Endotracheal Intubation

Difficult Airway. Definition The clinical situation in which a conventionally trained anesthesiologist experiences difficulty with mask ventilation, difficulty.

Airway Management L.Dadák, ARK FNUSA. Maintaining airway Noninvasive Noninvasive airwayairway laryngeal masklaryngeal mask combitubecombitube invasive.

Airway Management Dr. Omar Othman Emergency Medicine.

Airway Management & WuScope By R2 Liu Chih-Min.

1- For supporting ventilation in patient with some pathologic disease as:- : Upper airway obstruction : Respiratory failure : Loss of conciousness.

Q4.10 – October 2010Airway Management Essentials© Copyright 2010 American Safety and Health Institute Airway Management Essentials.

Emergency Department Of Rasool-Akram Hospital. Airway Management P. Hafezi MD Emergency Medicine.

Airway management and ventilation

Airway Complications of Intubation. Complications of Mechanical Ventilation Complications related to Intubation Mechanical complications related to presence.

Surgical and Nonsurgical Cricothyrotomy

DIFFICULT AIRWAY IN THE ICU Dr Anitha Shenoy Professor and Head of Anaesthesiology Kasturba Medical College, Manipal.

Project Undertaken by: Fritz Haimberger

CAP Module 4 - Difficult Airway Management (GHEMS_April2015)

Emergency Department.

Preoperative Assessment and Resuscitation Dr Mark Lambert Consultant Anaesthetist Royal National Throat, Nose and Ear Hospital Airway.

Emergency Airways Modification of Transtracheal Jet Ventilation and Retrograde Intubation Techniques BME 272 Senior Design Group 20 Project Undertaken.

Difficult Airways! Difficult Airways! Dr Mike Entwistle Consultant Anaesthetist, Royal Lancaster Infirmary NWTS Study Day 18/10/12.

Airway and Ventilation

Airway Management.

Airway Basics Matt Hallman, MD.

Jutarat Luanpholcharoenchai

Difficult Airway.

Unit 3 Lesson 3 Endotracheal Intubation

Unit 3 Lesson 1 Endotracheal Intubation

TEMS Regional Difficult Airway Course

Failure to maintain or protect airway Comatose (prevents aspiration) Airway trauma Failure of ventilation or oxygenation Ventilation failure not.

Project Undertaken by: Fritz Haimberger

CAP – Module 4 DIFFICULT AIRWAY MANAGEMENT

Presented by Nadeen hadidi

Tracheal intubation Done by : Mohammad Damseh.

Laryngeal mask & other oro and nasophargeal apparatus .

Intubation and anatomy of airway and Anesthesia apparatus

Laryngoscopic view grading system as initially developed by Cormack and Lehane.12 A: Grade I, the glottis is completely visible. Laryngoscopic view grading.

Presentation transcript:

Difficult Airway Management 2009 Adrian Sieberhagen

Clinical situation in which there is difficulty in Face Mask Ventilation and inability to intubate

What makes it difficult in ED’s Training/requirements Non-controlled setting Limited pre-procedural evaluation Hypoxia, hypotension, agitation, dynamic medical conditions Numerous logistical & implementation issues

Predicting the Difficult Airway History Physical Examination

History

Cormack and Lehane Class I: the vocal cords are visible Class II the vocals cords are only partly visible Class III only the epiglottis is seen Class IV the epiglottis cannot be seen.

Pregnancy Inflammatory Disease Small mouths Infections Endocrine Congenital Trauma Foreign Body Tumours

Examination

LEMON Look for external deformities Evaluate rule Mallampati Obstruction Neck Mobility

Mallampati Score Class I –visualization of the soft palate, fauces, uvula, and both anterior and posterior pillars Class II –visualization of the soft palate, fauces, and uvula Class III –visualization of the soft palate and the base of the uvula Class IV –soft palate is not visible at all

Thyromental Distance 6.5cm normal Sternomental Distance >12.5cm normal Protrusion of Mandible

Management Prearranged Emergency airway trolley available Most senior staff

Emergency Airway Trolley Rigid laryngoscope blades Tracheal tubes Tracheal tube guides Laryngeal Mask Airways Fibreoptic intubation equipment Non-invasive/minimally invasive airways Surgical Airway CO2 detectors

Management Prearranged Emergency airway trolley available Most senior staff Emergency airway algorithm Deliver supplemental O2

Alternative Airway Techniques LMA/Laryngeal Tube Transtracheal Jet Ventilation Fibreoptic Intubation Retrograde Intubation Lightwand Combitube Surgical Airway

Laryngeal Mask Lubricated LMA inserted into hypopharynx Tip in upper oesophogeal sphincter Inflate Cuff Muscle relaxants not necessary C/I: –Need for high Peak Pressures –Risk of Aspiration –Pts with low lung compliance

Laryngeal Tube

Transtracheal Jet Insuflation

Fibreoptic Intubation

Retrograde Intubation Place guidewire through cricothyroid membrane Guidewire passes cephalad through pharynx and out mouth/nose Railroad ET tube

Lightwand Flexible Inserted through ET tube Insert into larynx Light dims if entering oesophagus Limitations: Dark room

Combitube Double lumen tube Placed into hypopharynx blindly C/I –Oesophageal pathology

Surgical Airway Cricothyroidotomy –Complications: Bleeding Infection Vocal cord damage Tracheal stenosis –C/I <12yrs Laryngotracheal Disruption Coagulopathy

The End