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Airway and Ventilatory Managment

Airway and Ventilatory Managment. Objectives. Identify setting Regonize AWO Manage airway Define definitive airway. Coma Aspiration Facial trauma Neck trauma. Picture of bomb to face. Airway obstruction. Airway Obstruction Regonition. Look. Airway Obstruction Regonition. Listen.

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Airway and Ventilatory Managment

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  1. Airway and Ventilatory Managment

  2. Objectives • Identify setting • Regonize AWO • Manage airway • Define definitive airway

  3. Coma Aspiration Facial trauma Neck trauma Picture of bomb to face Airway obstruction

  4. Airway Obstruction Regonition • Look

  5. Airway Obstruction Regonition • Listen

  6. Airway Obstruction Regonition • Feel

  7. Adequate Breathing • Provide oxygen • Subtle deterioration of breathing • Caution! • Coma • SCI • Chest trauma

  8. Look Listen Inadequate Breathing

  9. Feel Adjuncts Inadequate Breathing

  10. Adequate oxygenation • Requires • Oxygen • Definitive airway • Ventilation • Caution • Protect C-spine

  11. Airway Maintenance • Chin lift • Jaw thrust • Oral airway • Nasal airway

  12. Need for Airway Coma Maxillofacial injury Aspiration Airway injury Need for Breathing Apnea Hypoxia Hypercapnia Brain injury Definitive Airway Definitive aw = cuffed tube in trachea

  13. Definitive Airway • Orotracheal • Nasotracheal • Surgical airway

  14. Right Bronchial intubation • Xray of right bronchial intubation

  15. RSI • Be prepared for surgical airway • Requires skill and training • Urgency must justify risk

  16. Surgical Airway • Indications • Inability to intubate the trachea • Maxillofacial trauma • Neck injury • Methods • Needle • Surgical

  17. Defnintive Airway:Immediate need:Apneic patient • Protect c spin • Oxgyenate ventilate • Orotracheal intubation (No nasotracheal intubation b/c of apnea) • If unable to intubate  surgical airway

  18. Defnintive Airway:Immediate need:Breathing patient • Protect c spine • Oxgyenate ventilate • Oro or nasotracheal intubation, maintain c-spine position • If unable to intubate  surgical airway

  19. Defnintive Airway:Immediate need:Maxillofacial trauma • Protect c spine • Oxgyenate and ventilate as needed • If unable to intubate  surgical airway

  20. Oxygenate and Ventilate • Goal = achieve maximal cellular oxygen • O2 at 10-12 L/min • Tight fitting mask with resevoir • Ventilate • Avoid prolonged intubation attempts

  21. Pulsoximeter Measures oxygenated hemoglobin Utility Difficult intubation Transport Pa02 vs sat 90 = 100% 60 = 90% 30 – 60% Monitor Oxygenation

  22. Oxygen – Hb dissociation curve

  23. Questions on this section?

  24. Summary • Suspect airway compromise • Protect C-spine • Open airway and ventilate • If in doubt  definitive airway • Adequate oxygen delivery

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