By

Adrianne Gonzaga
 Learning Objectives:

1 2 3 4
Define Airway Describe Airway Identify different List and Describe
management Anatomy Healthcare Issues different
and How they techniques and
affect the airway. adjuncts in
Managing Airway
Airway Management
• Airway management refers to the
set of techniques and
interventions used to establish
and maintain a patient's airway
for effective breathing and
oxygenation.
• It involves assessing, securing,
and optimizing the patency of
the airway to ensure adequate
ventilation and oxygen exchange.
 Airway management

Airway
Inadequate Cardiopulmonary
Management: Ventilation Resuscitation
Indications

Decrease
Airway
Respiratory
obstruction
Effort
Decrease Respiratory Effort Airway Obstruction
Intrinsic (TBI) Unconsciousness; Foreign
Extrinsic (opioids) Body; Injury; Secretions

Silent Noisy

Difficult to assess Easier to detect

Rate, pattern and depth Universal Choking Sign

 Airway
management
Airway
Management Children Adult
: By Age
Range Airway foreign bodies Emergency conditions
Potentially life- • Foreign body • Blunt or penetrating injury
• Epiglottitis • Upper airway burns
threatening
• Croup • Anaphylaxis
causes • Bacterial tracheitis • Laryngotracheomalacia
• Retropharyngeal abscess • Hereditary angioedema
• Peritonsillar abscess • Vocal cord dysfunction
• Infectious mononucleosis • Laryngospasm
 MILD OBSTRUCTION
Ability to speak
Encourage continuing
Hoarse cry
coughing
Forceful cough
Good air entry
Stay and monitor
Inspiratory stridor
Snoring (stertor)
Take steps if progress to
Minimal or no retractions severe obstruction
No nasal flaring or
grunting
 SEVERE OBSTRUCTION
Universal Choking sign
Unable to speak or cry Take steps to relive
Poor or no air entry obstruction: Abdominal
Retractions thrusts/ Chest thrusts/
Back thrusts
nasal flaring
Prolonged inspiratory No Blind finger-sweeps
time
CPR when unconscious
Tachypnea
Audible inspiratory stridor
loss of consciousness
Management
• History and Examination
• Radiological images and
Endoscopy
• Positioning Manoeuvres
• Airway Adjuncts
• Patient position
• Breathing Techniques
• Cervical fixation technique
Anatomic Considerations: Adult Vs. Children
 • Oxygenation and Ventilation
PHYSIOLOGIC • Hemodynamic Stability
CONSIDERATIO • Intracranial Pressure
NS
• Aspiration Risk
• Patient Comfort and Cooperation
• Communication and Teamwork
 Head Tilt & Chin Lift
•Treatment of suspected upper airway obstruction
in obtunded or unresponsive patients
•Part of initial emergency treatment for apnea or
impending respiratory arrest
•Improvement of airway patency during BVM
ventilation and sometimes during spontaneous
breathing
•Confirmation of apnea
 Indication:
Often used on
Jaw-thrust patients with
maneuver cervical neck
problems or
suspected cervical
spine injury.
 Oropharyngeal Airway
• Pushing the tongue posteriorly
• too small a device is ineffective
• too large a device can obstruct
the larynx
• traumatizing the soft tissue
• in intact airway reflexes, induce
vomiting
Measuring
Nasopharyngeal Used when
Airway  OPA insertion is difficult
 oral trauma
 clenched Jaw
 semiconscious patient
 intact airway reflexes
Nasopharyngeal
Airway:
Selection and
Application
• Select NPAs based on length
• Measurement: Nostril to the earlobe or the
angle of the jaw
Nasopharynge
al Airway:
Precautions
• Long NPA may enter oesophagus
• Injury to the nasal mucosa
• Intracranial NPA Placement
 • A bag-valve-mask (BVM) is a manual
resuscitator device used in airway
management to deliver positive pressure
ventilation to patients who are unable to
Bag Valve breathe adequately on their own or require
Mask assistance during resuscitation efforts.
 BVM: • Preparation
Effective • Positioning
• Mask Application
Technique
• Ventilation
Technique
• Monitoring
• Team Dynamics
 • Stomach Inflation
• Overinflation more
harmful than
Safety hyperventilation
Consideration • tidal volumes 6 to7
s mL/kg
• 10 breaths each
minute
• Each breath over 1
second
Endotracheal Tube
Endotracheal Tube

Indications:

Severe Respiratory Distress or Failure

General Anesthesia

Protection of the airway

Facilitation of secretion management

Endotracheal Tube
Procedure:
• Performed by an advanced
practitioners with adequate training
• Preoxygenation
• Positioning
• Awake or Sedated
• Insertion
• Verification
• Securing
Endotracheal Tube
Ventilation and Monitoring
• BVM or Mechanical Ventilator
• Continuous Monitoring

Troubleshooting
• Prompt recognition and
management of complications
• Repositioning
Summary

• Successful airway management requires a systematic

approach, adequate training, and regular practice.
• Adapting interventions to the patient's unique needs and
continuously monitoring the airway are essential for
ensuring patient safety and optimizing outcomes during
airway management procedures
• EMS practitioners should ensure adequate training before
handling any airway adjuncts.
Thank You