airway mgmt part 2

airway mgmt part 2 - Airway Management: Part 2 EMS...

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Airway Management: Part 2 EMS Professions Temple College
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Risks/Protective Measures Be prepared for: Coughing Spitting Vomiting Biting Body Substance Isolation Gloves Face, eye shields Respirator, if concern for airborne disease
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ALS Airway/Ventilation Methods Gastric Tubes Nasogastric  Caution with esophageal disease or facial trauma Tolerated by awake patients, but uncomfortable Patient can speak Interferes with BVM seal Orogastric Usually used in unresponsive patients Larger tube may be used Safe in facial trauma
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ALS Airway/Ventilation Methods Nasogastric Tube Insertion Select size (French) Measure length (nose to ear to xiphoid) Lubricate end of tube (water soluble) Maintain aseptic technique Position patient sitting up if possible
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ALS Airway/Ventilation Methods Nasogastric Tube Insertion Insert into nare towards angle of jaw Advance gradually to measured length Have patient swallow Assess placement Instill air, ausculate aspirate gastric contents Secure May connect to low vacuum (80-100 mm Hg)
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ALS Airway/Ventilation Methods Orogastric Tube Insertion Select size (French) Measure length Lubricate end of tube Position patient (usually supine) Insert into mouth Advance gradually but steadily Assess placement (instill air or aspirate) Secure Evacuate contents as needed
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ET Introduction Endotracheal Intubation Tube into trachea to provide ventilations  using BVM or ventilator Sized based upon inside diameter (ID) in mm Lengths increase with increased ID (cm  markings along length) Cuffed vs. Uncuffed
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Endotracheal Intubation Advantages Secures airway Route for a few medications (LANE) Optimizes ventilation, oxygenation Allows suctioning of lower airway
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Endotracheal Intubation Indications Present or impending respiratory failure Apnea Unable to protect own airway
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Endotracheal Intubation These are NOT  Indications Because I can intubate Because they are unresponsive Because I can’t show up at the hospital  without it
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Endotracheal Intubation Complications Soft tissue trauma/bleeding Dental injury Laryngeal edema Laryngospasm Vocal cord injury Barotrauma Hypoxia Aspiration Esophageal intubation Mainstem bronchus intubation
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Endotracheal Intubation Insertion Techniques Orotracheal Intubation (Direct Laryngoscopy) Blind Nasotracheal Intubation Digital Intubation Retrograde Intubation Transillumination
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Orotracheal Intubation Technique Position, ventilate patient Monitor patient ECG Pulse oximeter Assess patient’s airway for difficulty Assemble, check equipment (suction) Hyperventilate patient (30-120 sec)
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This note was uploaded on 11/13/2010 for the course EMS 432 taught by Professor Johnson during the Spring '10 term at NMT.

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airway mgmt part 2 - Airway Management: Part 2 EMS...

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