Review of Airway Maintenance and Obstructed Airway Care

COURSE: EMT-B AIRWAY DRILL

Session Reference: 1

Topic: Review of Airway Maintenance and Obstructed Airway Care

Level of Instruction: 3

Time Required: 3 hours

Materials: Chalkboard, CPR and Airway Manikins, Oropharyngeal and Nasopharyngeal Airways, Suctioning Unit and Catheters

Reference: Emergency Care, 7th Edition, Brady

PREPARATION:

Motivation:

Objective (SPO): 1-1

The student will demonstrate airway maintenance and obstructed airway maneuvers according to AHA standards.

Overview:

Review of Respiratory System and Its Function

   * System Components and Importance of Proper Ventilation

   * Opening and Maintaining Airways of Adults, Children, and Infants

   * Suctioning

   * Performing Artificial Ventilations

SESSION 1 Review Of Respiratory System and Its Function

SPO 1-1 The student will demonstrate airway maintenance and obstructed airway maneuvers according to AHA standards.

1-1 Name the major structures of the respiratory system.

1-2 Demonstrate the proper techniques to open the airway of an adult, child, and infant.

1-3 Describe the techniques of suctioning the airway.

1-4 Describe the steps to artificially ventilate a patient with a bag-valve mask for one and two rescuers.

The Airway Drill is designed for individuals who are currently first responders or EMT-B’s. The drill should be mostly practical with only a short lecture on respiratory structure.

I . Major Structures of The Respiratory System (1-1)

A. Components of the System

  1. Nose and mouth

  2. Pharynx

      i. Oropharynx

      ii. Nasopharynx

  3. Epiglottis

  4. Trachea (windpipe)

  5. Cricoid cartilage

  6. Larynx (voice box)

  7. Bronchi

      i. bronchioles

      ii. alveoli

  8. Lungs

  9. Diaphragm

B. Importance of Proper Ventilation

  1. Oxygen exchange through alveoli

  2. Circulation of oxygen to cells

  3. Oxygen/carbon dioxide exchange through capillaries

  4. Respiratory Rates

      i. Adult - 12 to 20/minute

      ii. Child - 15 to 30/minute

      iii. Infant - 25 to 50/minute

 

I I . Opening and Maintaining the Airway (1-2)

A. Adult

  1. Head-tilt, chin lift (no spinal injury)

  2. Jaw thrust (spinal injury suspected)

  3. Measure and insert oropharyngeal or nasopharyngeal airway

      i. Oropharyngeal measured from corner of mouth to tip of earlobe (Alternate measure from center

         of mouth to angle of Jaw)

      ii. Insert oropharyngeal airway with tip toward roof of mouth and rotate after past uvula

      iii. Nasopharyngeal - use largest that will fit in nostril without force - usually can judge by size of

          patient’s little finger

      iv. Insert nasopharyngeal by pushing tip of nose upward. Place in right nostril with bevel toward

          septum.

B. Child

  1. Head-tilt, chin lift - NEUTRAL ALIGNMENT

  2. Jaw Thrust

  3. Measure and insert an oropharyngeal airway.

      i. Measure same as for adult.

      ii. To insert, push down on tongue and pull up on jaw. Insert with tip pointing toward the tongue

          and throat.

C. Infant - NEUTRAL ALIGNMENT

  1. Head-tilt, chin-lift (no spinal injury)

  2. Jaw Thrust (suspected spinal injury)

  3. Measure and insert an oropharyngeal airway.

      i. Measure same as for adult.

      ii. To insert, push down on tongue and pull up on jaw. Insert with tip pointing toward the tongue

          and throat.

 

III. Suctioning (1-3)

A. Purpose

  1. Remove blood, liquids, and food particles.

  2. Can be used to remove teeth and other foreign bodies.

  3. When gurgling sound is heard.

B. Types of Units

  1. Suction devices are mounted or portable – electrical and hand operated

  2. Use hard/rigid or soft catheters.

C. Proper Technique

  1. Hard catheters should only be inserted as far as you can see to suction mouth and oropharynx. Use

      rigid catheter for infant and children.

  2. Soft catheters used for suctioning where a rigid catheter cannot be used - measure so that it is only

      inserted as far as base of tongue.