呼吸道通气方法ALS3

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,Airway&Ventilation Methods:ALS,Curved(Macintosh)Blade,Visualize anatomy,Insert from right to left,Lift upward and away,Blade in vallecula,Lift epiglottis indirectly,From AHA ACLS,Airway&Ventilation Methods:ALS,Straight(Miller)Blade,Visualize anatomy,Insert from right to left moving tongue away,Lift upward and away,Blade past vallecula and over epiglottis,Lift epiglottis directly,From AHA ACLS,Tube Positioning,From TRIPP,CPEM,Airway&Ventilation Methods:ALS,Blind Nasotracheal Intubation,Position&Oxygenate patient,Monitor patient,ECG Monitor,Pulse oximeter,Assess for BNI difficulty or contraindication,Assemble&check equipment,Lubricate end of tube;Do not warm,Attach BAAM(if available),Airway&Ventilation Methods:ALS,Blind Nasotracheal Intubation(cont),Position patient(preferably sitting upright),Insert tube into largest nare,Advance slowly but steadily,Listen for sound of whistle via BAAM,Advance tube,Inflate cuff&Assess placement,Secure&Reassess,Airway&Ventilation Methods:ALS,Digital Intubation,Blind technique,Variable probability of success,Using middle fingers to locate epiglottis,Lift epiglottis,Slide lubricated tube along side fingers,Assess tube placement&depth as with orotracheal intubation,Airway&Ventilation Methods:ALS,Digital Intubation,From AMLS,NAEMT,Airway&Ventilation Methods:ALS,Surgical Cricothyrotomy,Indications,absolute need for a definitive airway AND,unable to perform ETT due for structural or anatomic reasons,AND,risk of not intubating is than surgical airway risk,OR,absolute need for a definitive airway AND,unable to clear an upper airway obstruction,AND,multiple unsuccessful attempts at ETT,AND,other methods of ventilation do not allow for effective ventilation and respiration,Airway&Ventilation Methods:ALS,Surgical Cricothyrotomy,Contraindications(relative),No real demonstrated indication,Risks benefits,Age 8 years(some say 10),evidence of fx larynx or cricoid cartilage,evidence of tracheal transection,Airway&Ventilation Methods:ALS,Surgical Cricothyrotomy,Tips,Know your anatomy,Short incision,avoid inferior trachea,Incise,Do not saw,Work quickly.Have a plan,Be prepared with a backup plan,Airway&Ventilation Methods:ALS,Needle Cricothyrotomy&Transtracheal Jet Ventilation,Indications,Same as surgical cricothyrotomy along with,Contraindication for surgical cricothyrotomy,Contraindications,None when demonstrated need,caution with tracheal transection,