1. Airway

2. Learning Objectives At the end of this session you will be able to Describe the main aims of airway management in trauma Predict specific difficulties with the trauma airway Describe basic and advanced airway techniques

3. Main Goals Patency Protection Oxygenation Ventilation

4. Airway control in trauma Direct threats Indirect threats Ventilatory control Anticipated clinical course

5. Assessment Look Listen (voice) Palpate, and inspect neck (TWELVEC) Anticipate difficulty Continual reassessment

6. Signs of compromise Agitated / Comatose patient Change phonetics - hoarseness Obstructive sounds - snoring, gurgling Tachypnoea, use of accessory muscles Subcutaneous emphysema Hypoxia - LATE SIGN

7. What is a “difficult airway”?

8. Predicting Difficulty BVM (MOANS) Laryngoscopy (LEMON) SGA insertion (RODS) Cricothyroidotomy (SHORT)

9. Basic Airway techniques Oxygen Manoeuvres Suction Adjuncts

10. Advanced airway techniques Endotracheal intubation Supra-Glottic Airway Surgical Airway Pre-oxygenate !!

11. Pre-oxygenation Non rebreathe face mask + nasal cannulae BVM + nasal cannulae NIV + nasal cannulae Delayed sequence intubation + nasal cannulae

13. Unexpected difficult airway

18. Summary Goals of airway management Assessment Management Difficult airway

20. Learning Objectives You will now be able to: Describe the main aims of airway management in trauma Predict specific difficulties with the trauma airway Describe basic and advanced airway techniques