Download MBBS Neuroanaesthesia PPT 2 Basic Airway Managment Lecture Notes

--- Content provided by‌ FirstRanker.com ---

? Which conditions need Airway management
? How to Recognise Severity of problem
? Different approach of Management for adult and children
? Familiarization to techniques of basic airway management
? Assessing your Knowledge gain

--- Content provided by‌ FirstRanker.com ---

Basic Airway management

Inadequate

Cardiopulmonary

--- Content provided by FirstRanker.com ---

Ventilation

Resuscitation

--- Content provided by FirstRanker.com ---

Decrease

Respiratory

Airway obstruction

--- Content provided by‌ FirstRanker.com ---

Effort

Decrease Respiratory Effort

--- Content provided by‌ FirstRanker.com ---

Airway Obstruction

Intrinsic (ICH)

Unconsciousness; Foreign

--- Content provided by​ FirstRanker.com ---

Extrinsic (opioids)

Body; Injury; Secretions

--- Content provided by FirstRanker.com ---

Silent

Noisy

Difficult to assess

--- Content provided by⁠ FirstRanker.com ---

Easier to detect

Rate, pattern and depth

--- Content provided by⁠ FirstRanker.com ---

Accessory Muscle
Basic airway

management

--- Content provided by⁠ FirstRanker.com ---

Children

Adult

Airway foreign bodies

--- Content provided by⁠ FirstRanker.com ---

Emergency conditions

Potentially life-threatening causes

--- Content provided by​ FirstRanker.com ---

? Foreign body

? Blunt or penetrating injury

? Epiglottitis

--- Content provided by⁠ FirstRanker.com ---

? Upper airway burns

? Croup

--- Content provided by⁠ FirstRanker.com ---

? Anaphylaxis

? Bacterial tracheitis

? Laryngotracheomalacia

--- Content provided by FirstRanker.com ---

? Retropharyngeal abscess

? Hereditary angioedema

--- Content provided by‍ FirstRanker.com ---

? Peritonsillar abscess

? Vocal cord dysfunction

? Infectious mononucleosis

--- Content provided by FirstRanker.com ---

? Laryngospasm
MILD OBSTRUCTION

Ability to speak

--- Content provided by‌ FirstRanker.com ---

Hoarse cry

Encourage continuing

--- Content provided by‌ FirstRanker.com ---

coughing

Forceful cough

Good air entry

--- Content provided by​ FirstRanker.com ---

Stay and monitor

Inspiratory stridor

--- Content provided by​ FirstRanker.com ---

Snoring (stertor)

Take steps if progress to

Minimal or no retractions

--- Content provided by‌ FirstRanker.com ---

severe obstruction

No nasal flaring or

--- Content provided by‍ FirstRanker.com ---

grunting

SEVERE OBSTRUCTION

Universal Choking sign

--- Content provided by‍ FirstRanker.com ---

Unable to speak or cry

Take steps to relive

Poor or no air entry

--- Content provided by‍ FirstRanker.com ---

obstruction: Abdominal

thrusts/ Chest thrusts/

--- Content provided by‍ FirstRanker.com ---

Retractions

Back thrusts

nasal flaring

--- Content provided by FirstRanker.com ---

Prolonged inspiratory time

No Blind finger-sweeps

--- Content provided by‍ FirstRanker.com ---

Tachypnea

CPR when unconscious

Audible inspiratory stridor

--- Content provided by‍ FirstRanker.com ---

loss of consciousness
Management

? History and Examination

--- Content provided by‌ FirstRanker.com ---

? Radiological images and Endoscopy
? Positioning Manoeuvres
? Airway Adjuncts
? Patient position
? Breathing Techniques

--- Content provided by‍ FirstRanker.com ---

? Cervical fixation technique
WWW.SMSO.NET

Anatomic considerations in children

--- Content provided by⁠ FirstRanker.com ---

? Prominent occiput
? Small mouth opening
? Large tongue, tonsils and adenoids
? Superior laryngeal position
? Weaker hyoepiglottic ligament

--- Content provided by FirstRanker.com ---

? Large, floppy epiglottis
? Shorter trachea
? Anatomic subglottic narrowing
PHYSIOLOGIC CONSIDERATIONS

--- Content provided by⁠ FirstRanker.com ---

? Age-related high respiratory rate
? Periodic breathing and Apnoea
? Preferential nasal breathing
? Smaller tidal volumes relative to body size (6 to 8 mL/kg)
? Lower functional residual capacity

--- Content provided by FirstRanker.com ---

? Higher oxygen metabolism: (6 versus 3 mL/kg/min)
? Prone to respiratory fatigue: lower percentage of type 1 muscle

fibres

--- Content provided by​ FirstRanker.com ---

? Higher vagal tone


Head Tilt & Chin Lift

--- Content provided by FirstRanker.com ---

Head Tilt & Chin Lift
Jaw-thrust manoeuvre

Jaw-thrust manoeuvre in children
Oropharyngeal Airway by Arthur Guedel

--- Content provided by⁠ FirstRanker.com ---

? Pushing the tongue posteriorly
? too small a device is ineffective
? too large a device can obstruct

--- Content provided by‍ FirstRanker.com ---

the larynx

? traumatizing the soft tissue
? in intact airway reflexes, induce

--- Content provided by‌ FirstRanker.com ---

vomiting
Nasopharyngeal Airway

Used when

--- Content provided by FirstRanker.com ---

? Select NPAs based on length

? OPA insertion is difficult

? nostril to the earlobe or the

--- Content provided by‍ FirstRanker.com ---

angle of the jaw

? oral trauma
? clenched Jaw

--- Content provided by⁠ FirstRanker.com ---

? Intracranial NPA placement

? semiconscious patient

--- Content provided by‍ FirstRanker.com ---

? long NPA may enter oesophagus

? intact airway reflexes

? Injury to the nasal mucosa

--- Content provided by⁠ FirstRanker.com ---

Sniffing position

Recovery Position
Breathing Techniques: Bag Valve Mask

--- Content provided by​ FirstRanker.com ---

? Developed by Holger Hesse & Henning Ruber in 1953
? AMBU company: Artificial Manual Breathing Unit
? Manual Resuscitator or Self Inflating Bag
? Provides PPV in emergency or Temporary Ventilation
? Disposable or Reusable

--- Content provided by​ FirstRanker.com ---

? Sizes: Infant , children and adult

Components
Complications

--- Content provided by⁠ FirstRanker.com ---

? Stomach Inflation
? Overinflation more harmful

than hyperventilation

--- Content provided by FirstRanker.com ---

? tidal volumes 6 to7 mL/kg
? 10 breaths each minute
? Each breath over 1 second
? Lung Injury with ETT
Flow Volume Loops in Airway obstruction

--- Content provided by​ FirstRanker.com ---