呼吸机检测及参数-1.pptVIP

Airway management can be divided into BASIC AND ADVANCED MANAGEMENT Basic airway maneuvers Relieving obstruction by the head tilt is easy and effective. A hand firmly placed on the forehead tilts the head backward on the atlanto-occipital joint The chin lift is completed by placing the fingers of the one hand under the bony part of the lower jaw and lifting the chin forward. Note The tongue and posterior pharynx is lifted away from the posterior pharynx The head tilt, jaw thrust, mouth open (triple airway maneuver) is used when other methods have failed to open the airway. The head is tilted back in extension and the fingers of both hands grasp the ramus of the mandible which is displaced forward and upward. Both thumbs are then used to open the lower lips. BEWARE OF PATIENTS WITH CERVICAL SPINE INJURIES - SEE TRAUMA LECTURE Oropharyngeal airways may be useful to prevent soft tissues from obstructing the airway in the unconscious patient at the levels of the soft palate, epiglottis and base of tongue. An oropharyngeal airway may establish an adequate airway for spontaneous or bag-mask ventilation when proper head positioning is insufficient. It is inserted with the concavity facing the palate and then rotated 1800 into the proper position as it is advanced. Additional points Complications Gagging\, laryngospasm, or vomiting. Mucosal trauma, worsening the obstruction by pressing the epiglottis against the laryngeal outlet or displacing the tongue more posteriorly. Essential intubation equipment must be prepared and checked (tricks to remember ‘x plastics/y metals/suction etc” standard laryngoscope and blades (Macintosh sizes 2, 3 and 4) bougie, stylet syringe for cuff inflation Magill forceps, large artery forceps oral airways endotracheal tubes of various sizes catheter mount (device to connect circuit to endotracheal tube) Drugs Suction Note position of epiglottis at base of tongue. Note laryngoscope blade is in front of the epiglottis and not