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Includes the Adobe Acrobat Reader for reading and printing publications.

Numerous illustrations and matrices.

Contains the following key public domain (not copyrighted) U.S. Government publication(s) on one CD-ROM in both Microsoft PowerPoint and Adobe Acrobat PDF file formats:

TITLE: Airway Management and Oxygen Therapy, 141 pages (slides)

SLIDE TOPICS and CONTENT:

Airway Management and Oxygen Therapy

Terminal Learning Objective

Given a simulated patient and all the necessary equipment and materials, manage a patient's airway and provide oxygen therapy.

Enabling Learning Objective a

Given a list of airway management and oxygen therapy terms and definitions, match the term with its correct definition.

Terms and Definitions

Aspiration - the act of "breathing in" foreign matter e.g., vomitus, water, etc, into the lungs.

Bag-valve mask (BVM) - a hand-held device with a face mask and self-refilling bag that can be squeezed to provide artificial ventilations to a patient. The BVM can deliver air from the atmosphere or oxygen from a supplemental oxygen supply system.

Bag Valve Mask

Terms and Definitions

Carbon dioxide (CO2) - waste from the body's cells that is expelled through exhalation; key element in affecting rate and quality of breathing.

Flow meter - a valve that indicates the flow of oxygen in liters per minute (lpm).

Terms and Definitions

Hypoxia - a lack of oxygen to body’s cells and tissues.

Nasal cannula (NC) - flexible, clear plastic tubing with prongs inserted into the nares; delivers low percentages of oxygen to non-critical patients or persons who cannot tolerate a face mask.

Nasal Cannula

Terms and Definitions

Airway adjunct - device placed in the nasal or oral cavity to maintain passageway for flow of air to mouth, pharynx, and/or lungs.

Hypoxemia - deficient oxygenation of the blood.

Terms and Definitions

Nasopharyngeal airway - a flexible breathing tube inserted through the patient’s nose into the pharynx to help maintain an open airway.

Non-rebreather mask - oxygen delivery device that contains a plastic reservoir bag which must be pre-inflated prior to applying to a patient; used to administer high percentages of oxygen.

Nasopharyngeal Airway

Non-rebreather Mask

Terms and Definitions

Oropharyngeal airway (J-TUBE) - a semicircular air-way adjunct made of hard plastic or rubber; placed in oral cavity to prevent tongue or jaw from occluding upper airway.

Oxygen (O2) - colorless, odorless, tasteless gas essential for human respiration.

Oropharyngeal Airway

Terms and Definitions

Oxygen humidifier - a device connected to the flow-meter that adds moisture to oxygen to prevent the mucous membranes from drying and causing irritation.

Pocket face mask - soft, clear plastic, airway management device; forms airtight seal around mouth and nose to allow mouth-to-mask ventilation and provide barrier for spread of infection.

Oxygen Humidifier

Pocket Face Mask

Terms and Definitions

Pressure regulator - device attached to a pressurized cylinder to reduce delivered gas flow pressure to safe levels.

Simple face mask - device that delivers moderate levels (8-10 lpm) of oxygen.

Pressure Regulator

Simple Face Mask

Terms and Definitions

Suctioning - method used to remove materials from the airway through negative air pressure.

Suction catheter - flexible plastic tube used for suctioning material from the airway; measured in "French" (Fr.), with diameter increasing as number increases e.g., 14 Fr. is larger than an 8 Fr.

Suctioning Unit

Suction Catheter

Terms and Definitions

Venturi mask - O2 delivery device that allows delivering of specific concentration of oxygen; commonly used for stable Chronic Obstructive Pulmonary Disease (COPD) patients.

Yankauer (tonsil-tip) - a rigid plastic device that is used to remove foreign matter from the oral cavity and/or pharynx.

Venturi Mask

Yankauer

Enabling Learning Objective b

Given a scenario, select the purpose and indications for oxygen therapy.

Purpose and Indications for Oxygen Therapy

Purpose.

To provide oxygen for patients who are not breathing spontaneously.

To provide supplemental oxygen to breathing patients whose respirations are rendering a poor air exchange.

Purpose and Indications for Oxygen Therapy

Indications for oxygen therapy.

Respiratory and cardiac arrest.

Myocardial infarction.

Stroke.

Lung disease or injury.

Acute drug overdose.

Purpose and Indications for Oxygen Therapy

Smoke and toxic inhalation.

Chest injury.

Head injury.

Shock.

Major blood loss.

CAUTION:

Never withhold oxygen from a patient if their condition requires its use.

Enabling Learning Objective c

Given a scenario, select the purpose, indications, and procedures for insertion and removal of an oropharyngeal and nasopharyngeal airway adjuncts.

QUESTION:

What is an airway adjunct?

ANSWER:

Device placed in nasal or oral cavity to maintain airflow to mouth, pharynx, and/or lungs.

Oropharyngeal Airway (J-tube)

Purpose - to hold the tongue away from the back of the throat, thereby preventing an airway obstruction.

Indication - utilized for the unconscious patient without a gag reflex.

Oropharyngeal Airway (J-tube)

Oropharyngeal airway (J-tube)

Oropharyngeal insertion procedures.

Place patient on a flat surface in a supine position.

Non-trauma patient - use head-tilt, chin-lift method.

Trauma patient - minimize neck movement using jaw-thrust maneuver.

Jaw-thrust Maneuver

Oropharyngeal airway (J-tube)

Maintain airway by utilizing manual techniques and/or mechanical devices e.g., head-tilt, chin-lift, and jaw thrust airway adjuncts.

Select the proper size airway by measuring from the earlobe to the corner of the mouth or from the center of the patient’s mouth to the angle of the lower jaw bone.

Measuring

WARNING:

The 68P Radiology Specialist must practice infection control pre-cautions by utilizing gloves and other barrier devices when coming in contact with patients. Always follow your local protocol or standing operating procedures (SOP).

Oropharyngeal airway (J-tube)

With non-dominant hand, use the cross-finger technique to open the patient's mouth.

Visualize inside the mouth, and suction if necessary.

CAUTION:

Do not use the oropharyngeal airway if you see that the roof of the mouth is fractured or brain matter is exposed. The airway may enter the cranial cavity.

Oropharyngeal airway (J-tube)

Holding the adjunct in the dominant hand, position the correct size airway so that the tip is pointing toward the roof of the patient's mouth.

Insert airway into patient's mouth by sliding tip along the roof past the uvula or until resistance is met by the soft palate.

CAUTION:

DO NOT push the tongue or foreign matter into the back of the throat.

Oropharyngeal airway (J-tube)

Gently rotate the airway 180 degrees, so tip is positioned behind back of tongue

The flange of the airway should rest against the patient's lips.

WARNING:

If J-tube is too large for patient, more than a 1/4 of length protruding from lips, remove and choose proper size to prevent occlusion of airway.

Oropharyngeal airway (J-tube)

Administer oxygen, ventilate as necessary, IAW local protocols.

Monitor patient closely. If the patient gags or regains consciousness, remove the airway immediately.

Remove airway by pulling out with the natural curvature of the mouth, DO NOT rotate.

Nasopharyngeal airway

Purpose - to maintain an artificial airway for oxygen therapy or airway management when suctioning is necessary.

Nasopharyngeal airway

Indications:

Patient is conscious, semi-conscious or has a gag reflex.

Patient has injuries to mouth e.g., broken teeth, massive oral tissue damage.

Seizure patients who may have clenched teeth due to seizing.

CAUTION:

Do not use nasopharyngeal airway if there is evidence of head injury or if drainage of cerebrospinal fluid (CSF) from nose, mouth, or ears is present. CSF may indicate a skull fracture and the airway might enter the cranial cavity. Follow local protocols.

Nasopharyngeal airway

Nasopharyngeal insertion procedures:

Place the patient on a firm surface in the supine position with C-spine stabilized.

Nasopharyngeal airway

Select proper size nasopharyngeal airway.

Diameter - select an airway with a diameter smaller than the patient's nostril or one that is approximately the diameter of the patient's little finger.

Length - measure from tip of patient's nose to ear lobe.

Nasopharyngeal airway

Lubricate airway with a water soluble lubricant or sterile water if lubricant is not available.

Push tip of nose slightly up to expose opening in nostril.

Nasopharyngeal airway

Keeping the head in a neutral position, insert tip of airway through nostril.

Slowly advance tube along floor of nasal cavity until flange rest firmly against patient's nostril.

CAUTION:

If resistance is met during insertion, DO NOT continue. Stop, remove adjunct, re-lubricate and try other nostril. If resistance is still met, check proper size or use alternate artificial airway method.

Nasopharyngeal airway

Administer oxygen therapy and ventilate patient at this time if necessary. Follow local protocol.

To remove the airway, pull out with a steady motion along the curvature of the nasal cavity.

Enabling Learning Objective d

Given a list of oxygen equipment and characteristics, select the characteristics of each piece of oxygen equipment.