AIRWAY MANAGEMENT & ADVANCED AIRWAY MANAGEMENT

Upper airway

Consists of the nose, mouth, pharynx, and larynx.

Lower airway

Includes the trachea, bronchi, bronchioles, and alveoli.

Primary function of the airway

To warm, filter, and humidify air; conduct air to alveoli for gas exchange.

Differences in airway anatomy between adults and infants

Infants have a larger occiput, larger tongue, narrower airway, funnel-shaped larynx, and a soft trachea.

Inhalation

Active process where diaphragm contracts creating negative pressure, allowing air to enter lungs.

Exhalation

Passive process where diaphragm relaxes creating positive pressure, allowing air to leave lungs.

Clinical death

Characterized by no pulse and no breathing; potentially reversible condition.

Brain death

Permanent cessation of brain activity; irreversible condition.

Head-Tilt, Chin-Lift

Technique to open airway in unresponsive patients without suspected trauma.

Jaw Thrust

Technique used for trauma patients to open the airway without moving the neck.

Snoring during respiration

Indicates partial obstruction by the tongue.

Gurgling sounds

Indicate fluid in the airway; necessitates immediate suctioning.

Wheezes

Sounds due to lower airway narrowing from conditions like asthma and COPD.

Rales/Crackles

Sounds caused by fluid in the alveoli, often associated with CHF or pneumonia.

Diminished breath sounds

Indicate poor air movement as seen in COPD or pneumothorax.

Paradoxical movement

Occurs when a flail chest segment moves opposite to normal breathing.

OPA (Oropharyngeal Airway)

Used for unresponsive patients without a gag reflex; measured from the corner of the mouth to earlobe.

NPA (Nasopharyngeal Airway)

Used for semi-responsive patients with an intact gag reflex; measures from the tip of the nose to earlobe.

Suctioning duration for adults

No longer than 15 seconds; different time limits apply to children and infants.

Nasal Cannula flow

Delivers oxygen at a flow rate of 1-6 L/min, providing 24-44% oxygen concentration.

Non-Rebreather Mask flow

Provides oxygen flow of 10-15 L/min, achieving up to 90% oxygen concentration.

Bag-Valve Mask (BVM) flow

Delivers over 15 L/min, achieving nearly 100% oxygen concentration.

CPAP use

Effective for treating conditions like CHF and COPD, but contraindicated with specific conditions.

FBAO (Foreign Body Airway Obstruction) technique for conscious patients

Use abdominal thrusts to dislodge the obstruction.

Gastric distention cause

Caused by excessive ventilation pressure leading to risk of aspiration.

Agonal respirations

Characterized as ineffective gasping breaths indicating a need for BVM support.

Apnea definition

The condition of no breathing, treated with BVM and airway adjuncts.

Sellick Maneuver

Historically aimed at reducing aspiration; current practice uses it rarely.

SAMPLE assessment

Evaluates Signs/Symptoms, Allergies, Medications, Past medical history, Last oral intake, and Events leading up.

OPQRST assessment

Evaluates Onset, Provocation, Quality, Radiation, Severity, and Time regarding symptoms.

DCAP-BTLS assessment

A systematic method for evaluating injuries: Deformities, Contusions, Abrasions, Punctures, Burns, Tenderness, Lacerations, and Swelling.

Platinum 10 Minutes

Goal to assess, package, and transport critical trauma patients within 10 minutes.

Pertinent negatives

Symptoms that are expected but not present, important for diagnosis.

Patient refusals

Must assess capacity, explain risks, document, and obtain signature.

MCI (Mass Casualty Incident)

An incident with more patients than resources, requiring triage.