Principles of Airway Management

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Principles of Airway Management

• FFP Module 7

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Indications for airway protection

• Decreased level of consciousness
• GCS lt9
• Cerebral injury
• Surgery
• Medical problems

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Potential causes of airway obstruction

• Tongue
• Dentures
• Food stuffs
• Vomit
• Blood
• Secretions

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Techniques to clear material from airway

• Suction
• Postural airway manoeuvres
• Basic life support chocking protocol
• Up to 5 back slaps
• Up to 5 abdominal thrusts
• Only if unconscious up to 5 chest thrusts
• If unsuccessful to clear airway then Basic Life
  Support

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Opening the Airway

• Check the airway
• Open the airway, place one hand on the victims
  forehead and gently tilt head back
• Remove any visible obstruction from the victims
  mouth, including dislodged dentures. Leave well
  fitting dentures in place
• DO NOT ATTEMPT ANY FINGER SWEEPS

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Opening the airway
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Jaw thrust technique may be needed if C-spine
injury
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Simple airway adjuncts
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Nasopharyngeal airway insertion
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Oropharyngeal airway insertion
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Laryngeal Mask Airways
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The Laryngeal Mask Airway

• Latex-free, silicone rubber tube connected to an
  elliptical mask with an inflatable outer rim
• Standard 15 mm male adaptor
• Pilot tube and balloon attached to the inflatable
  outer rim
• Bars cover the connection between the tube and
  the mask
• Re-useable up to 40 times (Autoclave)

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Insertion Technique

• Open the mouth and press the tip of the cuff
  upward against the palate and flatten the cuff
  against it
• Use index finger to guide LMA, pressing backwards
  along the palate towards ears until resistance is
  felt
• The tip now rests in the hypopharynx

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Insertion Technique

• Use other hand to press down on LMA tube while
  removing index finger
• Inflate with 2-4 ml air to seal (60 cm H20
  maximum)
• Dont hold the tube while inflating the balloon,
  it moves outward a little as it seats properly

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LMA in Place
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Intubation
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Nasotracheal intubation
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Questions