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Advanced airway-management

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Dang Thanh Tuan
Dang Thanh Tuan
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Advanced Airway Management Part 4 The Difficult Airway By Steve Cole, CCEMT-P
… So I said “Hey Ya’ll…watch this”…………
Goals ,[object Object],[object Object],[object Object],[object Object]
What this class assumes : ,[object Object],[object Object],[object Object],[object Object],[object Object]
As Such: ,[object Object],[object Object],[object Object]
“ A mind once stretched by new Ideas never regains it original dimensions…”
Why do we Intubate? ,[object Object],[object Object],[object Object]
Ideal conditions for intubation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Ideal Pt. for intubation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
If only they looked this good…
Ped and Adult Normal Trachea
How many of our Pt’s are like That?
In Reality Our patients are: ,[object Object],[object Object],[object Object],[object Object],[object Object]
They Tend to look like This:
And This:
And This (after failed ETT attempt)
Most of our Patients are already “difficult airways” by “OR” Standards. Why should EMS personnel try to further identify a difficult airway?
 
The American Society of Anesthesiology (AMA)has noted: ,[object Object],[object Object],[object Object]
What does this mean to us? ,[object Object],[object Object],[object Object],[object Object]
How can we further identify a difficult airway? ,[object Object],[object Object],[object Object],[object Object],[object Object]
Past Medical History ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Past Medical History (Continued) ,[object Object],[object Object],[object Object],[object Object]
Basic Physical Exam ,[object Object],[object Object],[object Object],[object Object],[object Object]
ThyroMental Distance ,[object Object],[object Object],[object Object],[object Object],[object Object]
Dr. Binnions Lemon Law: An easy way to remember multiple tests… ,[object Object],[object Object],[object Object],[object Object],[object Object]
L: Look Externally ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
E: Evaluate the 3-3-2 rule ,[object Object],[object Object],[object Object]
M: Mellampati classification ,[object Object],[object Object],[object Object]
Mellampati Classification
Cormack & Lehane Grading
O: Obstruction? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
N: Neck Mobility ,[object Object],[object Object],[object Object],[object Object]
What do we do when we have a difficult airway?
The ASA calls a Failed/Difficult Laryngeoscopy a: ,[object Object],[object Object],[object Object],[object Object]
So what do we do?
A little pre-planning goes a long way…
Before intubation ,[object Object],[object Object],[object Object],[object Object],[object Object]
What are we going to do if we don’t get the Tube? ,[object Object],[object Object]
Plan “A”: (ALTERNATE) ,[object Object],[object Object],[object Object]
Plan “B”: (BVM and BLIND INTUBATION Techniques ) ,[object Object],[object Object],[object Object],[object Object],[object Object]
What do we do when faced with a Can’t Intubate Can’t Ventilate situation? ,[object Object]
Do YOU feel ready to enact Plans A, B, C at a drop of a hat? ,[object Object],[object Object],[object Object]
OK , Here You Go! ,[object Object]

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Advanced airway-management

Notes de l'éditeur

  1. Place Axis photo here
  2. In most cases Pre-hospital airway needs managing regardless of difficulty , and the Paramedic is expected to do that, regardless of difficulty ….so what is the benefit of knowing a Fancy system?