airway obstruction and management
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Airway Obstruction and Management
Dr. Riaz Ahmed KhanAssociate Professor and Head Department of AnaesthesiologyRehman Medical Institute
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What is an Airway?
• Your 1st Year Knowledge of Physiology?
• The path air follows to get into and out of the lungs.
• The mouth and nose are the normal entry and exit ports.
• Entering air then passes through the back of the throat (pharynx), continues through the voice box (larynx), down the trachea, and finally out the branching tubes known as bronchi.
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Respiratory Anatomy
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Respiratory Physiology
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What will you do with the Injured Person Here?
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ATLS (Advanced Trauma Life Support)
• Performed in an injured / trauma patient
• Starts as BTLS on site of injury
• Consists of the following components:
1. Airway
2. Breathing
3. Circulation
• We will only discuss the AIRWAY part of the trauma protocol.
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What is Airway Obstruction?
• Any obstacle from Mouth to Lungs• May be Partial or Complete• Limitation of air entry into Lungs • Causing Lack of O2 Inflow or CO2
Outflow• Relieving obstruction is very important
for LIFE!
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Why is it Important to Maintain Airway?
• Sensitive organs like brain and heart can die within a few minutes without O2
• Patient becomes unconscious (hypoxia and hypercarbia) further risk of Aspiration
• Trauma patient Airway comes FIRST
• Crucial few minutes
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AIRWAY RESCUE METHODS1) MANUAL MANOEUVRES: • Mostly done at site, also in ambulance• Head tilt, chin lift, jaw thrust• Clearing mouth with hooked finger
2) INSTRUMENTATION:• If above unsuccessful, mostly ambulance/hospital facility• Various artificial airways like Ambu Bag, Oropharyngeal
and Nasopharyngeal Airway, Endotracheal Tube, Laryngeal Mask Airway
3) SURGICAL AIRWAY:• If 2nd Option unsuccessful, almost always in hospital• Surgical Creation/Bypass of Airway • Anatomical Landmarks Important• Only skilled professional should attempt• Includes Cricothyroidotomy and Tracheostomy.
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MANUAL MANOEUVRES
See for Any Response / Call Name Call for Help / Ambulance
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MANUAL MANOEUVRES (cont….)
Head Tilt and Chin Lift (Opens the Oral Airway if Tongue Obstruction)
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MANUAL MANOEUVRES (cont….)Hear for Breathing, see chest movements If NO then start Mouth to Mouth Breaths, but Nose must be pinched to Avoid Leakage of Air
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MANUAL MANOEUVRES (cont….)LATERAL LYING POSITION FOR A BREATHING UNCONSCIOUS PATIENT
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Artificial Airways
AMBU Bag and Procedure (Remember to do Head Tilt and Chin Lift to Open the Airway otherwise Bagging will be Ineffective)
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Artificial Airways (cont…)Oropharyngeal Airway (Guedel Airway)
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Artificial Airways (cont…)
Nasopharyngeal Airway
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Artificial Airways (cont…)
Laryngeal Mask Airway
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Artificial Airways (cont…)Laryngoscope with Various Sizes of Blades (Left Picture) Used to Intubate Endotracheal Tube with Cuff (Right Picture)
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Artificial Airways (cont…)
Laryngoscopic View of Epiglottis and Glottis (Laryngeal Opening) and Endotracheal Tube In Place
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