Correlograma (análisis de autocorrelacion)

Airway patency may be impaired by the loss of normal muscle tone or by obstruction. In unconscious patient relaxation of the tongue, neck and pharyngeal muscles causes soft tissue obstruction of the supraglottic airway. This may be corrected by simple manual airway clearance procedures like; chin left, jaw thrust, cervical spine considerati

It provides an open airway when patient lying on side or on back during Expired Air

Support the jaw at the point of the chin in such a way that there is no pressure on the soft tissues of the neck. Because the tongue is attached to the lower jaw, this assists in opening of the airway. The chin is supported at the point by the knuckle of the middle finger, with the little and ring fingers clear of the soft tissues of the neck. The r lies along the line of the jaw. The thumb is placed along the front of the lower jaw between the lower lip and point of the chin and is used to open the mouth slightly. This manoeuvre should not hyperextend the neck. This is useful for trauma

not compromising the cervical spine.22, 29

Chin lift

OPENING OF AIRWAYS

Page 34

Airway patency may be impaired by the loss of normal muscle tone or by obstruction. In unconscious patient relaxation of the tongue, neck and pharyngeal muscles causes soft tissue obstruction of the supraglottic airway. This may be corrected by simple manual

chin left, jaw thrust, cervical spine consideration

It provides an open airway when patient lying on side or on back during Expired Air

Support the jaw at the point of the chin in such a way that there is no he neck. Because the tongue is attached to the lower jaw, this assists in opening of the airway. The chin is supported at the point by the knuckle of the middle finger, with the little and ring fingers clear of the soft tissues of the neck. The r lies along the line of the jaw. The thumb is placed along the front of the lower jaw between the lower lip and point of the chin and is used to open the mouth slightly. This manoeuvre should not hyperextend the neck. This is useful for trauma

AIRWAY MANAGEMENT (2) Jaw Thrust

Use: It provides an open airway when patient lying on side or on back during EAR as an

alternative to head tilt or chin lift.

Technique: In jaw thrust procedure position of

operator’s 3rd, 4th and 5th fingers is around the angle of the mandible while index fingers are placed on the body of the mandible and thumbs are placed over the zygoma bilaterally. Then apply pressure with the

bend in the jaw just below the ear) to thrust the jaw forward along with backward head tilt is used to opens the airway. Used with face mask on a bag

good seal and adequate ventila

Check for signs of breathing:

Look for rise and fall of the chest Listen for air movement

Feel for air movement at the mouth and/or nose

It provides an open airway when patient lying on side or on back during EAR as an alternative to head tilt or chin lift.

In jaw thrust procedure position of operator at the top of the head. Position of operator’s 3rd, 4th and 5th fingers is around the angle of the mandible while index fingers are placed on the body of the mandible and thumbs are placed over the zygoma bilaterally. Then apply pressure with the fingers behind the angles of the jaw (the sharp bend in the jaw just below the ear) to thrust the jaw forward along with backward head tilt is used to opens the airway. Used with face mask on a bag-valve device assists with a good seal and adequate ventilation.22

Check for signs of breathing:

Look for rise and fall of the chest Listen for air movement

Feel for air movement at the mouth and/or nose

Jaw Thrust

Page 35

It provides an open airway when patient lying on side or on back during EAR as an

operator at the top of the head. Position of operator’s 3rd, 4th and 5th fingers is around the angle of the mandible while index fingers are placed on the body of the mandible and thumbs are placed over the zygoma fingers behind the angles of the jaw (the sharp bend in the jaw just below the ear) to thrust the jaw forward along with backward head tilt valve device assists with a

OPENING OF AIRWAYS

AIRWAY MANAGEMENT Page 36

(3) CERVICAL SPINE CONSIDERATIONS

Remember - the airway is more important than cervical spine

Stabilise cervical spine if trauma or concern regarding the neck; Manage patient in supine aligned position

Rigid collar, head support, tape

Rigid collar should stay in place until C spine ‘cleared’ Unable to ‘clear’ the c-spine without X-ray/CT if

GCS < 15 Patient intubated

Affected by drugs or alcohol Painful distracting injuries Don’t forget pressure care

AIRWAY MANAGEMENT Page 37 (4) SUCTION

Equipment for suction clearance of the oropharynx is essential for the provision of life support. Yankauer sucker (for mouth) Y-suction catheter (for naso and oropharynx)29:

Attach to suction tubing

Position conveniently near patients head Turn on control device

Open patient’s mouth and insert sucker into lower corner of mouth gently

Occlude control hole for no greater than 5 seconds whilst withdrawing sucker

Move tip of sucker within the oral cavity gently to remove secretions and foreign objects as required

Repeat as required

Remember:

Excessive suctioning may traumatise airway mucosa Hypoxia may result from prolonged suctioning

Suctioning may cause coughing, gagging and vomiting, all of which may raise intracranial pressure.

Suctioning may stimulate the vagus nerve, leading to bradycardia and hypotension.