8/4/2019 SO AirwayMgmt

1/1

NationalEMSStandingOrders

AirwayManagement

Wherestatedinthespecifictreatmentguidelinesassecureanairwayandadministersupplementaloxygenas

indicated,

the

following

guidelines

should

be

followed:

A. OpenAirway1. Manualmaneuvers2. Clearobstructionsusingtheappropriatetechniques/suction3. Ifnecessary,insertappropriateairwaydevicetomaintaintheairway(i.e.oropharyngeal,nasopharyngeal,

endotrachealtube,S.A.L.T.,Combitube/KingAirway,cricothyrotomy)

4. Intubateanyunconsciouspatientwithoutagagreflexi. monitorpatientspulseoximetryandcardiacrhythmatalltimestopreventunrecognizedhypoxiaii. hyperoxygenatepriortointubationattemptiii. ifnotabletoplacetubewithin30sec.,withdraw, hyperoxygenate,andreattemptiv. verifyplacementusingAmbutubecheckdevice,observingappropriatechestrise,endtidalCO2

monitoring,andauscultationofbreathsounds

v. orotrachealornasotrachealintubationasindicatedvi. securetubewithETtubeholder(pediatricusetape)vii. inthecardiacarrestsituation,initialairwaymanagementshouldbecompletedwithmanualmaneuvers,

&simpleadjuncts.

5. Aftertwounsuccessfulattemptsatintubationbydirectlaryngoscopy,hyperoxygenatethepatient,placeS.A.L.T.adjunct,hyperoxygenate,thenintubatethroughtheS.A.L.T.. TheS.A.L.T.isonlyindicatedin

patientsforwhom6.5mmthrough9.0mmETTisappropriate.

6. Nasotrachealintubationandnasalairwaysshouldbeavoidedinthepatientwithfacialtrauma,orsuspectedbasalskullfracture

7. Extremecautionshouldbeexercisedinanypatientexperiencingsignificantheadinjury,orwithsignsofrisingintracranialpressure

8. Withsuspectedheadinjuries,administerLidocaine1.5mg/kgpriortoETTintubationtohelppreventriseinICP.

9. ForanypatientwithaGCS