Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time Unlocking airway management skills the key to patient survival 1 Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time Respiratory Anatomy Nose and mouth warms moistens and filters air Pharynx Oropharynx Nasopharynx Epiglottis Trachea windpipe 2 Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time Upper Airway Tongue Glottis Epiglottis 3 Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time Respiratory Anatomy Cricoid cartilage Larynx voice box Bronchi Lungs Visceral pleura surface of lungs Parietal pleura internal chest wall Interpleural space potential space 4 Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time Lower Airway 5 Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time Respiratory Anatomy Diaphragm Inhalation active process Diaphragm and intercostal muscles contract increasing the size of the thoracic cavity Diaphragm moves slightly downward ribs move upward and outward The negative pressure in the chest cavity causes air flow into the lungs 6 Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time Respiratory Anatomy Exhalation passive process Diaphragm and intercostal muscles relax decreasing the size of the thoracic cavity Diaphragm moves upward ribs move downward and inward The positive pressure inside the chest cavity causes air flow out of the lungs 7 Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time Anatomical sources of ventilation problems Upper airway Lower airway Head neck Brain Spinal cord Chest wall 8 Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time Respiratory Physiology Oxygenation blood and the cells become saturated with oxygen Hypoxia inadequate oxygen levels in the blood Signs of Hypoxia Increased or decreased heart rate Altered mental status early sign Agitation Initial elevation of B P followed by a decrease Cyanosis often a late sign 9 Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time Alveolar Gas Exchange Oxygen rich air enters the alveoli during each inspiration Oxygen enters the blood in the capillaries as carbon dioxide enters the alveoli for exhalation 10 Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time Infant and Child Considerations Mouth and nose generally all structures are smaller and more easily obstructed than in adults Pharynx infant s and children s tongues take up proportionally more space in the mouth than adults Trachea windpipe Infants and children have narrower tracheas that are obstructed more easily by swelling Trachea is softer and more flexible in infants and children 11 Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time Infant and Child Considerations Cricoid cartilage like other cartilage in the infant and child the cricoid cartilage is less developed and less rigid It is the narrowest part of the infant s or child s airway Diaphragm chest wall is softer infants and children tend to depend more heavily on the diaphragm for breathing 12 Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time Opening the Mouth Crossed finger technique Inspect the mouth Vomit Blood Secretions Foreign bodies Be extremely cautious Fingers Gag or vomit 13 Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time Opening the Airway Head tilt chin lift maneuver Adults vs Infants and Children Jaw thrust maneuver 14 Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time Techniques of Suctioning BSI precautions Purpose Remove blood other liquids and food particles from the airway Some suction units are inadequate for removing solid objects like teeth foreign bodies and food A patient needs to be suctioned immediately when a gurgling sound is heard with artificial ventilation 15 Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time Types of Suction Units Mounted Suction Devices Fixed on board the ambulance 300mmHg pull on gauge when tubing is clamped Should be adjustable for infants and children 16 Our greatest weakness lies in giving up The most certain way to succeed is always to try just one more time Portable Suction Devices Electric battery powered Oxygen powered Hand powered Each device must have Wide bore thick walled non kink tubing Plastic collection bot