Airway Management

Respiration: breathing Ventilation: breathing in of air or oxygen or providing breaths artificially. Respiratory distress: increased work of breathing; sensation of shortness of breath Respiratory failure: reduction of breathing to the point where oxygen intake is not sufficient to support life. Respiratory arrest: stopping breathing completely. Artificial Ventilation: forcing air or oxygen into the lungs when the patient has stopped breathing or has inadequate breathing.

Review of Anatomy & Physiology Nose Mouth Pharynx Larynx Trachea Bronchi Bronchioles Alveoli Lungs Diaphragm

Signs of Adequate Breathing Adequate and equal lung expansion (look) Air entering and leaving chest (listen) Air moving out nose or mouth (feel) Typical skin color Rate, rhythm, quality and depth of breathing

Signs of inadequate breathing Absent or minimal chest movements Abdominal breathing No air can be felt or heard at nose or mouth. Absent or diminished breathing sounds Noises heard during breathing Too rapid or too slow breathing rate Very shallow or very deep breathing Cyanosis Inability to speak Intercostals retraction Nasal flaring

Care of inadequate breathing Opening & maintaining the airway Head tilt, chin left maneuver Jaw thrust maneuver Providing artificial ventilation to patient Mouth to mask Two rescuer bag valve mask Flow restricted, oxygen powered ventilation device One rescuer bag valve mask Providing supplemental oxygen Suctioning as needed

Airway Adjuncts Oropharyngeal airway Nasophayngeal airway

Rules of using airway adjuncts Used in unconscious patient who do not exhibit a gag reflex Open airway manually before using them Take care of pushing tongue into pharynx Stop insertion if patient begins to gag Maintain the use of airway opening maneuver Be ready to suction secretions as necessary Remove if patient regain consciousness ar started to gag Use infection control practices

Suctioning The use of a vaccum device to remove blood, vomitus and other secretions or foreign materials from the airway.

Oxygen Therapy It is one of the most important and beneficial treatments an EMT can provide. Hypoxia: is an insufficiency in supply of oxygen to the body tissues.

Conditions requiring oxygen Respiratory or cardiac arrest Heart attacks and strokes Shock Blood loss Lung diseases Broken bones and head injuries and more

Hazards of oxygen therapy Oxygen used in emergency care is stored under pressure Oxygen supports combustion, causing fire to burn more rapidly. Oxygen toxicity or air sac collapse Infant eye damage Respiratory depression or respiratory arrest

Oxygen Delivery Devices Nonrebreather mask Nasal cannula Venturi mask Simple face mask

Nonrebreather Mask Flow rate: 12 – 15 L/Min O2 Conc.: 80 – 90 % Use: inadequate breathing, cyanotic, cool, clammy, short of breath, suffering chest pain, suffering severe injuries, altered mental status patients.

Nasal Cannual Flow rate: 1 – 6 L/Min O2 Conc.: 24 – 44 % Use: for patients who cannot tolerate mask

Venturi Mask Flow Rate: varied, up to 15 L/Min O2 Conc.: 24 – 60 % Use: to deliver specific concentration

Simple Face Mask Flow Rate: 10 L/Min O2 Conc.: 40 – 60 % Use: moderate FiO2, mouth breathers