Chapter 9 - Airway Management

Glottic Opening

The entry point into the larynx

Epiglottis

A leaf-shaped cartilage that covers the larynx during swallowing to prevent food from entering the trachea

lower airway structures

trachea, bronchi, bronchioles, alveoli

carina

Point at which the trachea bifurcates (divides) into the left and right mainstem bronchi.

pulmonary capillaries

surround the thin tissue membranes of the alveoli; site of gas exchange in blood

Bronchioconstriction

Decrease in the size of respiratory airways

Stridor breath sounds

high-pitched, harsh sound caused by a spasm or swelling of the larynx or an obstruction in the upper airway

snoring

The sound of the soft tissue of the upper airway creating a partial obstruction of air flow

gurgling

indicates presence of fluid in the upper airway, need for suctioning

head tilt-chin lift maneuver

a technique used to open the airway of a patient with no suspected neck or spine injury

jaw-thrust maneuver

A technique used to open the airway of a trauma patient with possible neck or spine injury

conscious choking

abdominal thrusts

infant choking

5 back blows followed by 5 abdominal thrusts

Unconscious choking

-Retilt the head and attempt

a ventilation.

-Give 30 chest compressions.

-look inside the mouth and

remove the object if seen.

- Attempt ventilations.

most common impedance of open airway

loss of airway muscle tone

Airway Adjunts

--tools to keep the airway open

--two types: Oral airway and Nasal Airway

oropharyngeal airway (OPA)

A curved plastic device inserted into the patient's mouth to minimize obstruction of the airway caused by the tongue

nasopharyngeal airway (NPA)

A flexible tube that is inserted into a patient's nose to provide an open airway

gag reflex

vomiting or retching that results when something is placed in the back of the pharynx. This is tied to the swallow reflex.

Measuring OPA Size

Corner of the mouth to the tip of the earlobe

Measuring NPA Size

Tip or nose to tip of earlobe

Water-based lubricant

When inserting a nasopharyngeal airway, lubricate the outside of the tube with

King airway

Supraglottic airway device that uses two seals that creates a patent seal at the esophagus and pharynx

Laryngeal Mask Airway (LMA)

An airway consisting of a tube and small mask that is fitted internally over the patient's larynx.

Mounted Suction Devices

On-board the ambulance, should be powerful enough to provide an airflow of >40 lpm and create a vacuum of more than -300 mmHg

Portable Suction Devices

Should be capable of generating -300 mmHg of pressure when the suction hose is clamped. A pressure of -80 to -120 mmHg is generally necessary to provide adequate suction. Can be electric, oxygen, air or hand powered

rigid suction catheter

also known as a "tonsil tip" or Yankauer, best suited for suctioning the oral airway

Suction for no more than ___ seconds at a time.

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