BLS and Airway Management PDF

BLS and Airway Management ========================= Primary Survey -------------- Danger -- check for dangers to self and others Response -- check if pt is responsive Airway -- check if pt airway is patent and management of airway as required Breathing -- check breathing status Circulation --...

BLS and Airway Management ========================= Primary Survey -------------- Danger -- check for dangers to self and others Response -- check if pt is responsive Airway -- check if pt airway is patent and management of airway as required Breathing -- check breathing status Circulation -- check for pulse Defibrillation -- defib as required Haemorrhage -- check for life-threatening haemorrhage Set up of Equipment ------------------- - Cardiac equipment on left - Airway equipment on right Airway ------ Assessment - Check if airway is patent - Assess if pt can maintain their airway independently Signs of Decreased airway - Gurgling - Snoring - Stridor - Hoarse voice - Increased RR - Increased work of breathing - Decreasing SPO2 - Cyanosis - Visible signs of injury or swelling to neck or face Management - Positioning - Visual inspection of airway - Removal of any obstruction - Maintain patency **Neutral** - Opening of ear in line with clavicle **Sniffing** - Opening of ear in line with sternum **Head Tilt Chin Lift** - One hand on chin, one on scalp (thumb on forehead) - Tilt head back, open jaw **Jaw Thrust** - Thumbs on cheekbones, 2 or 3 fingers below angle of jaw and push jaw anteriorly **Triple Airway Manoeuvre** - Head tilt, jaw thrust, open mouth **Lateral Position** - Extend arm direction to roll patient - Other arm cross body in same direction - Lift leg furthest from rolling side so knee is bent - Tip pt ### Airway Positioning (when to do) Indications - Pt who are unable to maintain airway patency and require airway management Contraindications - NIL Precautions - C-spine damage ### Laryngoscopy - RAMPED and in SNIFFING position - Ensure suction is set up **Indications** - Pt with altered conscious state, requiring inspection of the airway **Contraindications** - Suspected or confirmed epiglottitis (inflammation and swelling of epiglottis) **Precautions** - NIL **How to Use** - Hold in pistol grip (fingers wrapped, thumb pointing up) - Tilt pt head back - Insert laryngoscope on right and pull tongue to left as progressing on tongue - If epiglottis isn't in view, press right hand on larynx - To remove with Magill's: - Close magill progressing along laryngoscope - Open forceps about 2cm from FBAO - Remove Removal of Solid Objects (Removal of FBAO using Magill's forceps) ----------------------------------------------------------------- - Magill Forceps - Laryngoscope **Indications** - Upper airway FBAO with altered conscious state **Contraindications** - Patients with an effective cough (gag reflex in tact) **Precautions** - NIL Primary Airway Adjuncts ======================= Oropharyngeal Airway -------------------- - Inserted into mouth - Hold tongue off epiglottis **Indications** - Support airway patency in the unconscious pt **Contraindications** - Trismus (restriction of the ROM of jaw) - Gag reflex - TBI/nTBI (traumatic and non-traumatic brain injury) with adequate ventilation and oxygenation **Precautions** - Incorrect size of placement can exacerbate airway obstruction **Insertion** 1. Choose appropriate size (top at lips and bottom at angle of jaw) 2. Tilt pt. head back 3. Insert upside down 4. When halfway down, twist Nasopharyngeal Airway --------------------- - Inserted into one or both nostril - Displace tongue and soft tissue anteriorly **Indications** - Support airway patency in the unconscious pt **Contraindications** - NIL **Precautions** - Facial fracture or base of skull fracture - Patients with a TBI/nTBI **Insertion** 1. Choose appropriate size (top to nostril and bottom at angle of jaw) 2. Tilt pt. head back 3. Open nose 4. Insert perpendicular to pt head and wiggle to insert Oxygenation =========== Oxygenation in the Spontaneously Ventilating Patient ---------------------------------------------------- Nasal Cannula - 2L/min = 30% FIO2 - 4L/min = 40% FIO2 - 6L/min = 48% FIO2 Simple Face Mask (Hudson Mask) - 8L/min = 50% FIO2 - 10L/min = 60% FIO2 Non-rebreather Mask - 10L/min = 90% FIO2 - 15L/min = 100% FIO2 **Indications** - SpO2 \