Basic Airway Mastery Respiratory Management Airway Adjuncts with by 0klOu69

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									Basic Airway Mastery –
Module 1 -


Mary Makris & Kevin Burgess
EMS Educators
PFA/PVHS
2010
In order to complete this training and earn authorization
to utilize the King tube, participants must complete and
pass each module, in the following order:
       1.     Anatomy & Physiology Review
       2.     Respiratory Emergencies
       3.     King Tube Facts and Utilization
       4.     Written Competency Exam
       5.     Practical Training – 4 stations
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This presentation will help provide a
review of the A&P that you learned in
EMT Basic school with additional depth to
help you make the best clinical decisions
in airway assessment and management in
the pre-hospital setting
Mouth and Nose – Shapes, Angles & Obstructions
Mouth, Tongue, Oropharynx




             Foreign Body?




                             POSITION!!
Infection?
                                          Swelling?
THROAT and Neck
Click on the underlined text to see the video
Allergic Reactions in which the trachea or throat swell closed, including allergic reactions to a bee
sting, peanuts, antibiotics (penicillin), and blood pressure medications (ACE inhibitors)

Chemical burns and reactions

Croup

Epiglottitis (infection of the structure separating the trachea from the esophagus)
Fire or burns from breathing in smoke

Foreign bodies -- such as peanuts and other breathed-in foods, pieces of a balloon, buttons, etc

Viral or bacteria infections Most infections are successfully managed by the body’s immune
system and resolve in a few days. Bacterial Infections that continue are treated with antibiotics.
Viral Infections may be treated with anti-viral medications but must be administered early in the
disease.

Peritonsillar or Retropharyngeal abscess

Throat cancer

Tracheomalacia

Trauma

Vocal cord problems
Symptoms vary depending on the cause, but some symptoms are common to all types of airway blockage. They
include:

Agitation or fidgeting

Bluish color to the skin (cyanosis)

Changes in consciousness

Choking

Confusion

Difficulty breathing

Gasping for air

Panic

Unconsciousness

Wheezing, crowing, whistling, or other unusual breathing noises indicating breathing difficulty
Physical examination may show:

Decreased breath sounds in the lungs

Rapid, shallow, or slowed breathing

Stridor or high pitched whistling
“NORMAL Sounds”

Abnormal Lung Sounds
Wheezing

Stridor (noisy breathing from air forced through narrowed breathing passages

Stridor II
Rhonchi (coarse crackles – or a “more
continious “sound”… stick to coarse and fine crackles for descriptive if
                                     you are unsure.



                  Rales (fine crackles)
Mechanical
•   Nares/OralPharynx Obstructed?
•   Position of Head/Jaw?
•   Swelling in Trachea or Larynx
•   Bronchial Blockage (swelling or FB?)
•   Alveoli full or collapsed?
•   Muscles functioning? (Diaphragm/Intercostals)
•   Nerves triggering muscle movement?
•      C-3,C-4,C-5 and Phrenic
More Mechanical…
•   Tension Pneumo, Flail chest….(everything is smushed)

•     CHF, Pneumonia, Toxins (fluid in alveoli)

•     Air is going in and out BUT
             Blood is not going round & round
             (no CO2/O2 Exchange)
And even more Mechanical

•   Abdominal Distention

•   Muscular “splinting” (it hurts when it moves)
What Could be Wrong?
CHEMICAL

CO2/O2 Levels in the blood
    “normal” trigger: CO2 gets too HIGH….
                        (get the “toxin” OUT)
    “Hypoxic” Trigger: O2 gets too low
                           (COPD patients)

Drugs : Narcotics, suppressive agents….

Acid/Base Disruption (pH levels): electricity
(nerve stimulation of muscles) doesn’t work “right” outside
What do you see?
 ?Anxiety? Position? Effort? Equal Expansion?

What do you hear?
    Full Sentences? Lung Sounds?

What do you feel?
    Crepitis? Swelling? Fractures?

Does the situation/patient make SENSE?
What is “normal”?
    Pulse Oximetry 92-100% (with good perfusion)

      CO2 : 35-45 and don’t forget to look
at the waveform!
Are you comfortable with the information
reviewed in this module?

If not, please contact your EMS Educator for
additional resources.

The objective of this module is to help improve
your understanding of the Anatomy and
Physiology of the Respiratory System and how it
may relate to your assessment of the patient
with Respiratory Distress. Was it met?

								
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