Basic Airway ABDULLAH ALSAKKA

EM CONSULTANT

Objectives Review airway anatomy

Review basic airway maneuvers

The Upper AirwayEpiglottis

Mandible

Frontal Sinus

Soft Palate

Trachea

Glottis

Esophagus

Vocal Cords

A

B

C

D

E

F

G

H

The Upper Airway Other Structures

◦ Nasopharynx◦ Oropharynx◦ Hypopharynx◦ Larynx

Functions

Functions of the Upper Airway Passageway for air Warm Filter Humidify Protection

◦ Gag Reflex◦ Cough

Speech

Upper and Lower Airways

The Lower AirwayPrimary Bronchi

Hyoid Bone

Right Lung

Secondary Bronchi

Tracheal Ligament

Trachea

Larynx

Esophagus

Left Lung

Trachea

A

B

C

D

E

F

G

H

I

J

Airway Anatomy Upper Airway

◦ Pharynx◦ Epiglottis◦ Glottis◦ Vocal cords◦ Larynx

Lower Airway◦ Trachea◦ Bronchi◦ Alveoli◦ Lung tissue, consisting of lobes and lobules (3 on

the right and 2 on the left)◦ Pleura

Airway Anatomy

www.aap.org/nrp/ images/CDIMAGE4.JPG

arytenoids & aryepiglottic folds

Basic Airway Maneuvers ALWAYS REMEMBER THE BASICS

These skills should be used prior to initiating any advanced airway technique◦ Head-tilt/chin lift◦ Jaw thrust◦ Modified jaw thrust (for trauma patients)◦ Sellick’s maneuver

Airway Management Techniques Patency Maneuvers

Head tilt with chin lift, or jaw-thrust maneuver

13

Opening the airway

14

15

Jaw thrust technique may be needed if C-spine injury

1.Oropharyngeal Airway Size is measured from the corner of the mouth to the angle of the jaw

Sizes range from 0-6

It holds the tongue away from the posterior pharynx, but does not isolate the trachea

R 17

Simple airway adjuncts

Oral Airway continued The oral airway is inserted with the curve towards the side of the mouth

Then rotated so that the curve of the airway matches the curve of the tongue

19

Oropharyngeal airway insertion

2.Nasopharyngeal Airway Soft plastic or rubber tube that is designed to pass just inferior to the base of the tongue

Passed through one of the nares and can be used in patients with an intact gag reflex

CONTRAINDICATED in cases of suspected or possible basilar skull fracture Sizes range from 17-26 cm in length and 6-9 mm internal diameter Measured from tip of the nose to the corner of the patients ear

Nasal Airway continued The nasal airway is lubricated with a water soluble lubricant

The beveled tip is inserted directed towards the septum, with the airway directed perpendicular to the face

If resistance is met, rotating the airway may help or the other nare may be used

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24

Nasopharyngeal airway insertion

Bag-Valve-Mask VentilationVery important skill to know

May provide temporary or definitive airway management.

One person - importance of a good seal.

Two person technique more effective.

In EMS setting may be as useful as endotracheal intubation.

Bag-Valve-Mask Ventilation