1. April 2004 Richard Lake 1 Principles of Airway Management FFP Module 7

2. April 2004Richard Lake2 Indications for airway protection Decreased level of consciousness Decreased level of consciousness GCS <9 GCS <9 Cerebral injury Cerebral injury Surgery Surgery Medical problems Medical problems

3. April 2004Richard Lake3 Potential causes of airway obstruction Tongue Tongue Dentures Dentures Food stuffs Food stuffs Vomit Vomit Blood Blood Secretions Secretions

4. April 2004Richard Lake4 Techniques to clear material from airway Suction Suction Postural airway manoeuvres Postural airway manoeuvres Basic life support chocking protocol Basic life support chocking protocol Up to 5 back slaps Up to 5 back slaps Up to 5 abdominal thrusts Up to 5 abdominal thrusts Only if unconscious up to 5 chest thrusts Only if unconscious up to 5 chest thrusts If unsuccessful to clear airway then Basic Life Support If unsuccessful to clear airway then Basic Life Support

5. April 2004Richard Lake5 Opening the Airway Check the airway Check the airway Open the airway, place one hand on the victims forehead and gently tilt head back Open the airway, place one hand on the victims forehead and gently tilt head back Remove any visible obstruction from the victims mouth, including dislodged dentures. Leave well fitting dentures in place Remove any visible obstruction from the victims mouth, including dislodged dentures. Leave well fitting dentures in place DO NOT ATTEMPT ANY FINGER SWEEPS DO NOT ATTEMPT ANY FINGER SWEEPS

6. April 2004Richard Lake6 Opening the airway

7. April 2004Richard Lake7 Jaw thrust technique may be needed if C-spine injury

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9. April 2004Richard Lake9 Simple airway adjuncts

10. April 2004Richard Lake10 Nasopharyngeal airway insertion

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13. April 2004Richard Lake13 Oropharyngeal airway insertion

14. April 2004Richard Lake14 Laryngeal Mask Airways

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17. April 2004Richard Lake17 The Laryngeal Mask Airway Latex-free, silicone rubber tube connected to an elliptical mask with an inflatable outer rim Latex-free, silicone rubber tube connected to an elliptical mask with an inflatable outer rim Standard 15 mm male adaptor Standard 15 mm male adaptor Pilot tube and balloon attached to the inflatable outer rim Pilot tube and balloon attached to the inflatable outer rim Bars cover the connection between the tube and the mask Bars cover the connection between the tube and the mask Re-useable up to 40 times (Autoclave) Re-useable up to 40 times (Autoclave)

18. April 2004Richard Lake18 Insertion Technique Open the mouth and press the tip of the cuff upward against the palate and flatten the cuff against it Open the mouth and press the tip of the cuff upward against the palate and flatten the cuff against it Use index finger to guide LMA, pressing backwards along the palate towards ears until resistance is felt Use index finger to guide LMA, pressing backwards along the palate towards ears until resistance is felt The tip now rests in the hypopharynx The tip now rests in the hypopharynx

19. April 2004Richard Lake19 Insertion Technique Use other hand to press down on LMA tube while removing index finger Use other hand to press down on LMA tube while removing index finger Inflate with 2-4 ml air to seal (60 cm H20 maximum) Inflate with 2-4 ml air to seal (60 cm H20 maximum) Don’t hold the tube while inflating the balloon, it moves outward a little as it seats properly Don’t hold the tube while inflating the balloon, it moves outward a little as it seats properly

20. April 2004Richard Lake20 LMA in Place

21. April 2004Richard Lake21 Intubation

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27. April 2004Richard Lake27 Nasotracheal intubation

28. April 2004Richard Lake28 Questions