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Aashish Parihar
m.sC. Nursing
Maintenanceofpatentairway
Maintenanceofpatentairway
Airways must remain free
from obstruction to enable
effective respiratory
function and thus sustain
life. Remember, if the
client has stopped breathing
instigate artificial
respirations immediately
Maintenanceofpatentairway
Airway management is the
medical process of ensuring
there is an open pathway
between a patient’s lungs and
the outside world, as well as
reducing the risk of aspiration.
Airway management is a primary
consideration
in cardiopulmonary
resuscitation, anesthesia, emer
gency medicine, intensive care
medicine and first aid
Maintenanceofpatentairway
Assessment of airway
Breathing pattern
Dyspnoea
Labored breathing
Breathing sound
Stridor
wheezing
Chest wall movement
Reverse movement of these, i.e. chest
sucked in and abdomen protruding
indicates an obstruction
Colour of skin
cyanosis
Maintenanceofpatentairway
Choking
unconsciousness
Panic
Maintenanceofpatentairway
Causes of airway obstruction
Foreign bodies
Aspiration of vomitus
Tracheolaryngeal trauma
Plugging of mucus
Diphtheria
Obstructive lung diseases
Tracheobronchitis
Maintenanceofpatentairway
Management
Removal of foreign bodies
Removal of vomit and regurgitation
Airway maneuvers
Invasive airway management
Maintenanceofpatentairway
Removal of foreign bodies
If you suspect an obstruction check
in the client’s mouth for any
obvious obstruction, e.g. vomit,
foreign body, etc. and remove
same by sweeping the mouth
with a finger. Great care should
be taken not to push any foreign
body further into the air passage
or
Perform abdominal thrusts also
known as Heimlich maneuver
Maintenanceofpatentairway
Removal of vomit and regurgitation
In the case of a patient who vomits or has other secretions
in the airway, these techniques will not be enough.
use suction to clean out the airway, although this may
not always be possible.
An unconscious patient who is regurgitating stomach
contents should be turned into the recovery
position when there is no suction equipment
available.
As this allows (to a certain extent) the drainage of fluids
out of the mouth instead of down the trachea.
The recovery position refers to one of a series of
variations on a lateral recumbent or three-quarters
prone position of the body, in to which
an unconscious but breathing casualty can be placed
as part of first aid treatment.
Maintenanceofpatentairway
AIRWAY MANEUVERS
Head-tilt chin-lift
Basic procedure used in
cardiopulmonary
resuscitation.
Rescuers one hand tilts
head back while other
hand is placed under the
chin to lift the mandible
and displace the tongue.
Maintenanceofpatentairway
AIRWAY MANEUVERS
Head-tilt chin-lift
 The head-tilt chin-lift is the primary maneuver
used in any patient in whom cervical spine injury
is not a concern.
 The simplest way of ensuring an open airway in an
unconscious patient.
 This is taught on most first aid courses as the
standard way of clearing an airway.
Maintenanceofpatentairway
AIRWAY MANEUVERS
Jaw-thrust maneuver
Index and middle fingers
are used to physically
push the posterior (back)
aspects of the mandible
upwards while their
thumbs push down on
the chin to open the
mouth.
Maintenanceofpatentairway
AIRWAY MANEUVERS
Jaw-thrust maneuver
 The jaw-thrust maneuver is an effective airway
technique.
 It is used in the patient in whom cervical spine
injury is suspected and is used on a supine patient.
 It prevents the fall of tongue thereby maintain the
patent airway.
Maintenanceofpatentairway
AIRWAY MANEUVERS
Cervical spine immobilization
Most airway maneuvers are associated with some movement of
the cervical spine (c-spine).
Even though collars for holding the head in-line can cause
problems maintaining an airway and maintaining a blood
pressure.
However, it is not recommended to remove the collar without
adequate personnel to manually hold the head in place.
Maintenanceofpatentairway
Invasive airway management
Oropharyngeal airway
Oropharyngeal airways (OPA) (also known
as Guedel airways) are rigid plastic
curved devices used to maintain an open
airway.
When a person becomes unconscious, the
muscles in their jaw relax and allow the
tongue to obstruct the airway.
An OPA should only be used in a deeply
unresponsive patient because in a
responsive patient they can cause
vomiting and aspiration.
Maintenanceofpatentairway
Invasive airway management
Nasopharyngeal airway
The nasopharyngeal airway (NPA) (also known
as a nasal trumpet) is a soft rubber or plastic
hollow tube that is passed through the nose
into the posterior pharynx.
It is used in the patient with jaw clenched or
semiconscious.
NPAs are generally not recommended if there is
suspicion of a fracture to the base of the
skull, due to the possibility of the tube
entering the cranium.
Maintenanceofpatentairway
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Maintenace of patent airway

  • 1. Prepared by: Aashish Parihar m.sC. Nursing Maintenanceofpatentairway
  • 2. Maintenanceofpatentairway Airways must remain free from obstruction to enable effective respiratory function and thus sustain life. Remember, if the client has stopped breathing instigate artificial respirations immediately
  • 3. Maintenanceofpatentairway Airway management is the medical process of ensuring there is an open pathway between a patient’s lungs and the outside world, as well as reducing the risk of aspiration. Airway management is a primary consideration in cardiopulmonary resuscitation, anesthesia, emer gency medicine, intensive care medicine and first aid
  • 4. Maintenanceofpatentairway Assessment of airway Breathing pattern Dyspnoea Labored breathing Breathing sound Stridor wheezing Chest wall movement Reverse movement of these, i.e. chest sucked in and abdomen protruding indicates an obstruction Colour of skin cyanosis
  • 6. Maintenanceofpatentairway Causes of airway obstruction Foreign bodies Aspiration of vomitus Tracheolaryngeal trauma Plugging of mucus Diphtheria Obstructive lung diseases Tracheobronchitis
  • 7. Maintenanceofpatentairway Management Removal of foreign bodies Removal of vomit and regurgitation Airway maneuvers Invasive airway management
  • 8. Maintenanceofpatentairway Removal of foreign bodies If you suspect an obstruction check in the client’s mouth for any obvious obstruction, e.g. vomit, foreign body, etc. and remove same by sweeping the mouth with a finger. Great care should be taken not to push any foreign body further into the air passage or Perform abdominal thrusts also known as Heimlich maneuver
  • 9. Maintenanceofpatentairway Removal of vomit and regurgitation In the case of a patient who vomits or has other secretions in the airway, these techniques will not be enough. use suction to clean out the airway, although this may not always be possible. An unconscious patient who is regurgitating stomach contents should be turned into the recovery position when there is no suction equipment available. As this allows (to a certain extent) the drainage of fluids out of the mouth instead of down the trachea. The recovery position refers to one of a series of variations on a lateral recumbent or three-quarters prone position of the body, in to which an unconscious but breathing casualty can be placed as part of first aid treatment.
  • 10. Maintenanceofpatentairway AIRWAY MANEUVERS Head-tilt chin-lift Basic procedure used in cardiopulmonary resuscitation. Rescuers one hand tilts head back while other hand is placed under the chin to lift the mandible and displace the tongue.
  • 11. Maintenanceofpatentairway AIRWAY MANEUVERS Head-tilt chin-lift  The head-tilt chin-lift is the primary maneuver used in any patient in whom cervical spine injury is not a concern.  The simplest way of ensuring an open airway in an unconscious patient.  This is taught on most first aid courses as the standard way of clearing an airway.
  • 12. Maintenanceofpatentairway AIRWAY MANEUVERS Jaw-thrust maneuver Index and middle fingers are used to physically push the posterior (back) aspects of the mandible upwards while their thumbs push down on the chin to open the mouth.
  • 13. Maintenanceofpatentairway AIRWAY MANEUVERS Jaw-thrust maneuver  The jaw-thrust maneuver is an effective airway technique.  It is used in the patient in whom cervical spine injury is suspected and is used on a supine patient.  It prevents the fall of tongue thereby maintain the patent airway.
  • 14. Maintenanceofpatentairway AIRWAY MANEUVERS Cervical spine immobilization Most airway maneuvers are associated with some movement of the cervical spine (c-spine). Even though collars for holding the head in-line can cause problems maintaining an airway and maintaining a blood pressure. However, it is not recommended to remove the collar without adequate personnel to manually hold the head in place.
  • 15. Maintenanceofpatentairway Invasive airway management Oropharyngeal airway Oropharyngeal airways (OPA) (also known as Guedel airways) are rigid plastic curved devices used to maintain an open airway. When a person becomes unconscious, the muscles in their jaw relax and allow the tongue to obstruct the airway. An OPA should only be used in a deeply unresponsive patient because in a responsive patient they can cause vomiting and aspiration.
  • 16. Maintenanceofpatentairway Invasive airway management Nasopharyngeal airway The nasopharyngeal airway (NPA) (also known as a nasal trumpet) is a soft rubber or plastic hollow tube that is passed through the nose into the posterior pharynx. It is used in the patient with jaw clenched or semiconscious. NPAs are generally not recommended if there is suspicion of a fracture to the base of the skull, due to the possibility of the tube entering the cranium.