Airway (airway) management
- Recognizing the signs of a threatened airway
- The techniques familiar to safeguard manually airway and manually ventilate
- explain the proper use of resources to secure the airway
- Preparing describe an endotracheal intubation
- describe alternative methods securing to the airway;
recognizing the signs of a threatened airway
How do we evaluate the airway and breathing of a patient?
Here the so-called. ABC methodology is a wonderful roadmap
A = Airway (Airway)
B = Breathing (Respiratory)
C = Circulation (Circulation)
Airway
Free Airway?
Signs clear airway
- No visible foreign objects, substances, liquids (FB) in the mouth / throat cavity
- no noise
- No use auxiliary respiratory muscles
- Symmetrical breathing movements
- Quiet breathing frequency
- good oxygenation
- No fear
- No other signs of "distress"
Threatened airway?
causes
congenital
subglottic stenosis
infectious
bacteria
mold
virus
Allergic
Acute edema (swelling)
mechanically
Aspiration
FB (foreign object)
Incineration (swelling)
Breathing
Effective Breathing?
Purpose of the breathing:
The breathing has for its object to provide, and to be able to discharge carbon dioxide (CO2), the body of sufficient oxygen (O2).
• speed (frequency) of breathing
Normopneu = N ormal respiratory rate
15-20 / min
Bradypnea = Too slow respiratory rate
<6 / min
Tachypnea = Too rapid respiratory rate, on deep breaths
> 20 / min)
Hyperventilation = Too rapid respiratory rate, deep breaths
• Respiratory Depth
Normal = 500ml tidal volume
• Effectiveness of breathing
It may be that there are breaths, only that they are not sufficiently effective, or may be an expression of underlying problems (s)
Gasp (agonal respiration)
An abnormal (pathological) breathing pattern, characterized by a hard, heavy, noisy, irregular and yawn-like way of breathing
Cheynes Stokes
Respiratory disorder in which periods of apnea (no breathing) alternate with periods of hyperventilation (too rapid breathing)
Hyperventilation
An abnormal (pathological) breathing pattern, characterized by a t e rapid respiratory rate, with deep inspirations
Kussmaul
an abnormal (pathological) breathing pattern, characterized by very deep, gasping breath. It is an unconscious mechanism that serves to compensate for acidification (acidosis) by breathing out carbon dioxide as possible
Jugdement
Purpose of review:
General aspects know and recognize; with the aim to evaluate the respiratory function (look, listen, feel)
• Audible breathing
'Depth information video "
- Snoring
- Stridor Example = click here
- Hoarseness
• Breathe Labor (Work of Breathing (WOB)
'Depth information video "
- Using respiratory muscles Example = click here
- nostrils Example = click here
- Withdrawals Example = click here
- substernal Withdrawals Example = click here
• Visible physical symptoms and manifestations
'Depth information video "
- Attitude Example = click here
- Cyanosis (skin) Example = click here
- Anxiety Example = click here
- (Reduced) awareness Example = click here
Interventions
If the airway obstruction was the original problem, eliminating the obstruction may be sufficient for recovery without further intervention is needed.
In an unconscious child / person to the tongue to the back pockets, making the airway is blocked and stops breathing.
Basic airway management
Head-tilt / chin-lift maneuver
In this case try to open the airway with the so-called head-tilt / chin-lift maneuver:
The rescuer places one hand on the head of the child, and the head tilts gently back to neutral position when the infant and sniffing position in the child.
The fingers of the other hand we place under the chin and lift it. Be careful not to damage the soft tissue by grasping too hard. By lifting the chin can happen that closes the mouth of the child, spread in this case with the thumb of the same hand lips.
We then assess the presence of a breath.
We do this in the following way:
LOOK to the motions of the chest and / or abdomen
LISTEN for breath sounds
FEEL to breath (tip: moisten your cheek, it's easier to feel)
The rescuer places his face over that of the child, with the ear above the nose and cheek above the mouth so he can watch the chest for up to 10 seconds.
Video: Click here
If it does not work with a head-tilt / chin lift maneuver to keep the upper airway open, or if the tilting of the main counter has been designated to be executed (for example, in trauma), the so-called jaw-thrust maneuver can.
Jaw thrust
jaw thrust
You do this by placing two or three fingers on both sides behind the jaw angle and thus lift the lower jaw.
This technique is easier when the worker rests his elbows on the ground which is the victim.
may be applied a low degree of head tilt, unless there is a neck trauma.
Video: Click here
Again, the success or failure of this intervention will be assessed using the LOOK-LISTEN-FEEL method.
In case of trauma to the head-tilt / chin lift maneuver can exacerbate an injury to a cervical vertebra. In general, the jaw thrust without head tilt method, the safest way to clear the airway.
Demonstration
BLS airway management (as part of a CPR / AED)
Video: Click here
Advanced Airway Management
This means that the airway management is done using (invasive) tools, this is reserved for professionals who are specially trained.
Steps:
Posts
Geen opmerkingen