1. CAP – Module 1 Basic Mechanical Airways CAP Module 1 - Basic Airway Mechanics (GHEMS_VApril2015)

2.  What is the most common obstruction? Soft Tissue Obstruction CAP Module 1 - Basic Airway Mechanics (GHEMS_VApril2015)

3. Soft Tissue Obstruction Objective CAP Module 1 - Basic Airway Mechanics (GHEMS_VApril2015)

4. Concept – Sizing - Insertion Nasal & Oral Airways CAP Module 1 - Basic Airway Mechanics (GHEMS_VApril2015)

5. Concept:  Soft Rubber  Funnel Projection  Beveled End Especially Useful:  Gag reflex still present  Clenched Teeth Nasopharyngeal Airway 20F to 36F CAP Module 1 - Basic Airway Mechanics (GHEMS_VApril2015)

6. Appropriate Size: Nostril size Smallest finger Nose to ear lobe Nasopharyngeal Airway CAP Module 1 - Basic Airway Mechanics (GHEMS_VApril2015)

7.  Lubricate !  Insert along floor of nasal  cavity  If resistance met, use back-  and forth motion  Don’t Force - Use other nostril If patient gags, withdraw slightly If patient gags, withdraw slightly Insertion Nasopharyngeal Airway CAP Module 1 - Basic Airway Mechanics (GHEMS_VApril2015)

8. Precautions: Basilar Skull Fracture Kink or Clog Nasal Damage Nose Bleeds Pt on Coumadin or Pradaxa Too long vs. Too Short Nasopharyngeal Airway CAP Module 1 - Basic Airway Mechanics (GHEMS_VApril2015)

9. Concept: - Rigid semicirclar device - Follows the palate’s curvature - Holds base of tongue away from posterior oropharynx Oropharyngeal Airway CAP Module 1 - Basic Airway Mechanics (GHEMS_VApril2015)

10.  Measure: 6 - 8 Sizes 40mm Infant 50mm Pediatric (#0) 60mm Pediatric (#1) 70mm Small Adult (#2) 80mm Small Adult (#3) 90mm Med Adult (#4) 100mm Adult (#5) 110mm Large Adult (#6) Oropharyngeal Airway CAP Module 1 - Basic Airway Mechanics (GHEMS_VApril2015)

11. Insertion: 1. Unconscious/No Gag 2. Insert - “backwards” 3. Rotate - 180 degrees as inserting Oropharyngeal Airway CAP Module 1 - Basic Airway Mechanics (GHEMS_VApril2015)

12. Precautions: Too Short = May not hold the tongue forward Too Long = May press the epiglottis against the entrance of the larynx. Oropharyngeal Airway CAP Module 1 - Basic Airway Mechanics (GHEMS_VApril2015)

13. Procedure Notes: Slow Rate Slow Ventilation Adult(5)Seconds * Child(4)Seconds * Infant(3)Seconds No O2 = 21% O2 = 60-70% Reservoir = 90-95% B ag V alve M ask CAP Module 1 - Basic Airway Mechanics (GHEMS_VApril2015)

14. Seal + Pressure + Path B ag V alve M ask CAP Module 1 - Basic Airway Mechanics (GHEMS_VApril2015)

15. GRAYS HARBOR COUNTY AIRWAY MANAGEMENT: GRAYS HARBOR COUNTY AIRWAY MANAGEMENT: GENERAL Indications Failure to oxygenate Failure to ventilate Failure to protect (the airway due to a decreased level of consciousness) CAP Module 1 - Basic Airway Mechanics (GHEMS_VApril2015)

16. GRAYS HARBOR COUNTY AIRWAY MANAGEMENT: GRAYS HARBOR COUNTY AIRWAY MANAGEMENT: GENERAL ALL EMS PROVIDERS: Head-tilt/Chin-lift or jaw thrust as appropriate Oropharyngeal airway (OPA) Nasopharyngeal airway (NPA) Bag-valve-mask assistance CAP Module 1 - Basic Airway Mechanics (GHEMS_VApril2015)

17. BLS Before ALS CAP Module 1 - Basic Airway Mechanics (GHEMS_VApril2015)