Upload
kameko-stone
View
86
Download
0
Tags:
Embed Size (px)
DESCRIPTION
AIRWAY MANAGEMENT. Respiratory Problems are the most common cause of Pediatric Arrest. Wanida Paoin Thammasat Hospital,Thammasat University. AIRWAY MANAGEMENT. Airway positioning, opening oro/nasopharyngeal airway Breathing mouth to mouth ( + nose) bag-mask laryngeal mask - PowerPoint PPT Presentation
Citation preview
Respiratory Problems
are the most common cause of
Pediatric ArrestWanida PaoinThammasat
Hospital,Thammasat University
๐Airway๐ positioning, opening๐ oro/nasopharyngeal airway
๐Breathing๐ mouth to mouth (+ nose) ๐ bag-mask๐ laryngeal mask๐ endotracheal intubation
Airway Anatomy & Physiology
Large tongueHigh glottis
Slanting vocal cord
Narrow cricoid ring
C4
C7
Narrower nares
Large occiputImmature laryngeal reflex
ทำ��ไมเด็กจึ�งห�ยใจึทำ�งจึม�กได็�ด็�กว่��ทำ�งป�ก ทำ��ไมจึ�งต้�องใช้� straight blade ในก�รใส่� ET tube ในเด็กอ�ย�น�อยกว่�� 2 ป� ทำ��ไม ET tube ในเด็กทำ�รกจึ�งเลื่ !อนหลื่�ด็ได็�ง��ย ทำ��ไมจึ�งส่�ม�รถใส่� ET tube ในเด็กทำ�รกได็�ง��ยขณะเด็กต้ !น ทำ��ไมจึ�งเลื่ อกใช้� uncuff-tube ในเด็กอ�ย�น�อยกว่�� 8 ป�
Airway Anatomy & Physiology
Loose tissue
Airway Anatomy & Physiology
• Position• Open the airway
– - head tilt chin lift maneuver– - jaw thrust maneuver– oropharyngeal and nasopharyngeal airway– - foreign body airway obstruction
Airway
head tilt-chin lift jaw-thrust
Oropharyngeal Airway
Nasopharyngeal Airway
Indication
Breathing•Assessment• Provide rescue breathing
–mouth-to-mouth-and-nose and mouth-to mouth– - bag mask ventilation– laryngeal mask airway– endotracheal intubation– ventilation through a tracheostomy or stoma
self inflatingsize > 450-500 ml.
“E-C clamp
gastric inflation cricoid pressure
visible chest risingavoid excessive ventilation
reservoirO 2 flow > - 10 15 L/min
O2
-conc. 60 95%opening the airway
appropriately sized mask
B - ag mask ventilation
• used in unconscious patient• contraindicted in a patient w
ith an intact gag reflex• eqivalent ventilation compar
e with ET tube• uncommom aspiration• more difficult to maintain th
an ET tube
Laryngeal Mask Airway
Laryngeal Mask Airway
•Advantages• Indications•Equipment•Procedure•Verification of proper
tube placement
Endotracheal Intubation
3 tracheal tube: cuff or uncuffsuction catheteroxygen sourceface maskself-inflating bag + PEEP valvestyletlubricantlaryngoscope blade and handleexhaled CO2 detectortape and equipment to immobilize
uncuffed tube: tracheal tube size (mm) = age in years + 4 4
cuffed tube: tracheal tube size (mm) = age in years + 3
4
Endotracheal tube size
•Advantages• Indications•Equipment•Procedure•Verification of proper
tube placement
Endotracheal Intubation
Displacemant
Deteriorating condition of an intubated patient
EquipmentfailurePneumothorax
Obstruction
๐Airway๐ positioning, opening๐ oro/nasopharyngeal airway
๐Breathing๐ mouth to mouth (+ nose) ๐ bag-mask๐ laryngeal mask๐ endotracheal intubation