A current guide to airway management in prehospital patient care

2021 ◽  
Vol 13 (4) ◽  
pp. 1-10
Author(s):  
Michael Sampson
Keyword(s):  
Airway Management ◽  
Major Trauma ◽  
Prehospital Care ◽  
Altered Consciousness ◽  
Anatomy And Physiology ◽  
Airway Assessment ◽  
Core Skill ◽  
Insertion Techniques ◽  
Airway Devices ◽  
A Current

A patent airway linking the nose and mouth with the lungs is essential to life. In emergency care, individuals may experience airway difficulties for many reasons including major trauma, airway inflammation and altered consciousness. Airway management is therefore a core skill for paramedics and other practitioners working in prehospital care. This article reviews the anatomy and physiology of the airway before moving on to consider causes of airway obstruction. A look-listen-feel approach to airway assessment is described, followed by a discussion of techniques used to clear, open and maintain the airway. Commonly used airway devices including oropharyngeal, nasopharyngeal and supraglottic airways are evaluated, and their indications and insertion techniques discussed. The use of endotracheal intubation by paramedics is also evaluated.

scholarly journals A guide to airway management

2021 ◽  
pp. 1-13
Author(s):  
Michael Sampson
Keyword(s):  
Airway Management ◽  
Airway Obstruction ◽  
Critically Ill ◽  
Anatomy And Physiology ◽  
Airway Assessment ◽  
Core Skill ◽  
Insertion Techniques ◽  
Airway Devices ◽  
Inflammatory Changes

A patent airway linking the nose and mouth with the lungs is essential to life. Critically ill people often experience airway difficulties for reasons including alterations in consciousness, the use of sedating medications, and inflammatory changes within the airway. Airway management is therefore a core skill for any clinician caring for critically ill people. This article briefly reviews the anatomy and physiology of the airway before moving on to consider causes of airway obstruction. A look-listen-feel approach to airway assessment is described, followed by a discussion of techniques used to clear, open and maintain the airway. Commonly used airway devices including oropharyngeal, nasopharyngeal and supraglottic airways are evaluated, and their indications and insertion techniques discussed. The role of the endotracheal tube in the critically ill person is also considered.

The airway in anaesthetic practice

2017 ◽  
Author(s):  
Christopher Frerk ◽  
Takashi Asai
Keyword(s):  
Airway Management ◽  
Preoperative Evaluation ◽  
Historical Context ◽  
Short Review ◽  
Tracheal Extubation ◽  
Tube Placement ◽  
Anatomy And Physiology ◽  
Audit Project ◽  
Airway Devices ◽  
Induction Of Anaesthesia

This chapter provides a comprehensive review of current airway management set against its historical context and likely future developments in the field. Developments in equipment design are discussed against the background of a short review of the anatomy and physiology relevant to clinical airway management. An exploration of airway devices examines progress in design from the first facemasks and early hands-free delivery systems, through to current second-generation supraglottic airways and the future of providing improved protection against aspiration. Continuing advances in tracheal tube and cuff design are set alongside developments in techniques and equipment for laryngoscopy and possibilities for supplementing capnography in confirmation of correct tube placement within the trachea. The use of newer drugs to facilitate control of airway reflexes is also discussed. The importance of using optimal evidence-based techniques in airway management is highlighted in the reduction of complications. This covers preoperative evaluation of the airway, planning a strategy, induction of anaesthesia, and establishing a clear airway through to safe termination of anaesthesia, emergence, tracheal extubation, and recovery. Techniques for dealing with complications if they arise are described. Drawing on lessons from the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society ‘Major complications of airway management in the United Kingdom’ (NAP4) and the general literature, emphasis is placed on high-risk areas of airway management and areas where the existing knowledge base is not covered in depth in other texts.

An Update on Airway Management

2020 ◽  
Keyword(s):  
Airway Management ◽  
Surgical Techniques ◽  
Daily Practice ◽  
Postoperative Management ◽  
Diagnostic Methods ◽  
Emergency Rooms ◽  
Specific Patient ◽  
Medical Practitioners ◽  
Preoperative Diagnostic ◽  
Airway Devices

In recent years, there have been many advances in the safe management of the patient's airway, a cornerstone of anesthetic practice. An Update on Airway Management brings forth information about new approaches in airway management in many clinical settings. This volume analyzes and explains new preoperative diagnostic methods, algorithms, intubation devices, extubation procedures, novelties in postoperative management in resuscitation and intensive care units, while providing a simple, accessible and applicable reading experience that helps medical practitioners in daily practice. The comprehensive updates presented in this volume make this a useful reference for anesthesiologists, surgeons and EMTs at all levels. Key topics reviewed in this reference include: New airway devices, clinical management techniques, pharmacology updates (ASA guidelines, DAS algorithms, Vortex approach, etc.), Induced and awake approaches in different settings Updates on diagnostic accuracy of perioperative radiology and ultrasonography Airway management in different settings (nonoperating room locations and emergency rooms) Airway management in specific patient groups (for example, patients suffering from morbid obesity, obstetric patients and critical patients) Algorithms and traditional surgical techniques that include emergency cricothyrotomy and tracheostomy in ‘Cannot Intubate, Cannot Ventilate’ scenarios. Learning techniques to manage airways correctly, focusing on the combination of knowledge, technical abilities, decision making, communication skills and leadership Special topics such as difficult airway management registry, organization, documentation, dissemination of critical information, big data and databases

scholarly journals Variation in Out-of-Hospital Cardiac Arrest Management

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Jason M. Jones ◽  
Joseph A. Tyndall ◽  
Christine M. Van Dillen
Keyword(s):  
Cardiac Arrest ◽  
Airway Management ◽  
Prehospital Care ◽  
Management Strategies ◽  
Retrospective Chart Review ◽  
Airway Device ◽  
Care Providers ◽  
One Airway ◽  
Time And Energy ◽  
Hospital Cardiac Arrest

Objective. To evaluate variation in airway management strategies in one suburban emergency medical services system treating patients experiencing out-of-hospital cardiac arrest (OHCA). Method. Retrospective chart review of all adult OHCA resuscitation during a 13-month period, specifically comparing airway management decisions. Results. Paramedics demonstrated considerable variation in their approaches to airway management. Approximately half of all OHCA patients received more than one airway management attempt (38/77 [49%]), and one-quarter underwent three or more attempts (25/77 [25%]). One-third of patients arrived at the emergency department with a different airway device than initially selected (25/77 [32%]). Conclusion. This study confirmed our hypothesis that paramedics’ selection of ventilation strategies in cardiac arrest varies considerably. This observation raises concern because airway management diverts time and energy from interventions known to improve outcomes in OHCA management, such as cardiopulmonary resuscitation and defibrillation. More research is needed to identify more focused airway management strategies for prehospital care providers.

Comprehensive Overview of Pediatric Airway Management

2019 ◽  
Author(s):  
Dale Woolridge ◽  
Lisa Goldberg ◽  
Garrett S. Pacheco
Keyword(s):  
Airway Management ◽  
Endotracheal Tube ◽  
Endotracheal Intubation ◽  
Emergency Physician ◽  
Laryngeal Mask ◽  
Volume Control ◽  
Comprehensive Overview ◽  
Insertion Depth ◽  
Pediatric Airway ◽  
Core Skill

Pediatric endotracheal intubation is a procedure that can be stress provoking to the emergency physician. Although the need for this core skill is rare, when confronted with this situation, the emergency physician must have knowledge of the anatomic, physiologic, and pathologic components unique to the pediatric airway to optimize success. Furthermore, the emergency physician should be well versed in the various equipment and adjuncts as well as techniques developed to effectively manage the pediatric airway. This review covers the pathophysiology and practice of endotracheal intubation. Figures show a gum elastic bougie; the Mallampati classification; appropriate oropharyngeal, laryngeal, and tracheal axes; advancing the laryngoscope to lift the epiglottis; endotracheal tube position in neonates; and synchronized intermittent mandatory ventilation pressure-regulated volume control mechanical ventilation. Tables list endotracheal tube sizes, neonatal endotracheal tube sizes, pediatric laryngeal mask airway sizes, commonly used induction agents, and endotracheal tube insertion depth guidelines. This review contains 6 figures, 8 tables, and 77 references. Key words: emergent tracheal intubation; endotracheal tube; laryngoscopy; pediatric airway; pediatric airway management; pediatric endotracheal intubation; pediatric laryngeal mask; video laryngoscopy

Comprehensive Overview of Pediatric Airway Management

2019 ◽  
Author(s):  
Dale Woolridge ◽  
Lisa Goldberg ◽  
Garrett S. Pacheco
Keyword(s):  
Airway Management ◽  
Endotracheal Tube ◽  
Endotracheal Intubation ◽  
Emergency Physician ◽  
Laryngeal Mask ◽  
Volume Control ◽  
Comprehensive Overview ◽  
Insertion Depth ◽  
Pediatric Airway ◽  
Core Skill

Pediatric endotracheal intubation is a procedure that can be stress provoking to the emergency physician. Although the need for this core skill is rare, when confronted with this situation, the emergency physician must have knowledge of the anatomic, physiologic, and pathologic components unique to the pediatric airway to optimize success. Furthermore, the emergency physician should be well versed in the various equipment and adjuncts as well as techniques developed to effectively manage the pediatric airway. This review covers the pathophysiology and practice of endotracheal intubation. Figures show a gum elastic bougie; the Mallampati classification; appropriate oropharyngeal, laryngeal, and tracheal axes; advancing the laryngoscope to lift the epiglottis; endotracheal tube position in neonates; and synchronized intermittent mandatory ventilation pressure-regulated volume control mechanical ventilation. Tables list endotracheal tube sizes, neonatal endotracheal tube sizes, pediatric laryngeal mask airway sizes, commonly used induction agents, and endotracheal tube insertion depth guidelines. This review contains 6 figures, 8 tables, and 77 references. Key words: emergent tracheal intubation; endotracheal tube; laryngoscopy; pediatric airway; pediatric airway management; pediatric endotracheal intubation; pediatric laryngeal mask; video laryngoscopy

Airway assessment and management

2021 ◽  
pp. 361-404
Author(s):  
Jules Cranshaw ◽  
Emira Kursumovic ◽  
Tim Cook
Keyword(s):  
Tracheal Intubation ◽  
Airway Management ◽  
Difficult Intubation ◽  
Rapid Sequence Induction ◽  
Respiratory Viruses ◽  
Airway Assessment ◽  
Rapid Sequence ◽  
Sequence Induction ◽  
Practical Information ◽  
Apnoeic Oxygenation

This chapter provides detailed, practical and up-to-date information on management of the airway. It demystifies airway terminology, outlines airway assessment, and describes the management of the unanticipated difficult airway in adults. It includes a new section on intubating critically ill patients using the vortex approach, and outlines the equipment and techniques used to aid airway management. It gives practical information on the emergency front of neck airway and strategies to approach the obstructed airway. It explains rapid sequence induction, inhalational induction, awake tracheal intubation, and extubation after difficult intubation. It contains new sections on apnoeic oxygenation and how to manage patients with airborne respiratory viruses.

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