Adult Airway Protocol (AA 1)

Vocabulary flashcards covering key definitions, criteria, mnemonics, and protocols from the Adult Airway protocol AA 1.

Goal Oxygen Saturation

Supplemental oxygen target of oxygen saturation $\ge 92\%$ during airway and breathing management.

Capnography Monitoring Requirements

Mandatory End-tidal ($EtCO_2$) monitoring following placement of an endotracheal tube, and mandatory following placement of a BIAD once available on scene.

Failed Airway

Condition defined as being unable to ventilate and oxygenate $\ge 90\%$ during or after one (1) or more unsuccessful intubation attempts; and/or anatomy inconsistent with continued attempts; and/or three (3) unsuccessful attempts by the most experienced Paramedic/AEMT.

HEAVEN Criteria

Criteria used to identify a potentially difficult or complicated airway, comprising Hypoxemia ($SpO_2 \le 93\%$ at initial laryngoscopy), Extremes of Size (pediatric patients $\le 8$ years of age or clinical obesity), Anatomic Abnormalities, Vomit/Blood/Fluid, Exsanguination, and Neck Mobility.

Secure Airway

For the purposes of protocol AA 1, a status defined as when the patient is receiving appropriate oxygenation and ventilation.

Protocol Ventilation Rate

Ventilation rate of $10 - 12$ per minute to maintain an $EtCO_2$ of $35 - 45$ and avoid hyperventilation.

ROMAN Mnemonic

Mnemonic used for predicting Difficult BVM Ventilation: Radiation treatment/Restriction; Obese/Obstruction/OB (2nd and 3rd trimesters)/Obstructive sleep apnea; Mask seal difficulty (hair, secretions, trauma); Age $\ge 55$; No teeth.

LEON Mnemonic

Mnemonic used for predicting Difficult Laryngoscopy: Look externally for anatomical problems; Evaluate 3-3-2; Obese, obstruction, OB (2nd and 3rd trimesters); Neck mobility limited.

Evaluate 3-3-2 Rule

Assessment metric where mouth opening should equal 3 of patient's finger widths, mental area to neck should equal 3 of patient's finger widths, and base of chin to thyroid prominence should equal 2 of patient's finger widths.

RODS Mnemonic

Mnemonic used for predicting Difficulty with BIAD placement: Radiation treatment/Restriction; Obese/Obstruction/OB (2nd and 3rd trimesters)/Obstructive sleep apnea; Distorted or disrupted airway; Short thyromental distance/Small mandible.

SMART Mnemonic

Mnemonic used for predicting Difficulty with Cricothyrotomy / Surgical Airway: Surgery scars; Mass or hematoma, Access or anatomical problems; Radiation treatment to face, neck, or chest; Tumor.

Intubation Attempt Definition

Defined as the laryngoscope blade passing the teeth or the endotracheal tube passed into the nostril.