简易呼吸器使用 (3).ppt

* * An oropharyngeal airway is an ideal way to restore the patency of an airway thats become obstructed by the tongue in an unconscious patient—or to aid in ventilation during a code. This device, which is easily inserted at the bedside, can also be used to facilitate suctioning in an unconscious or semi-conscious patient and can prevent him from biting his tongue and the inside of his lips and cheeks (though its not indicated for someone whos actively seizing). Knowing how to properly insert an oropharyngeal airway is the best way to ensure an optimal and injury-free outcome. But before we review how its done, lets take a look at the two most common types of devices. The Berman and Guedel airways Oropharyngeal airways are generally made of hard plastic, and have a semicircular design that conforms to the curvature of the palate. When properly inserted, an oropharyngeal airway will hold the tongue away from the posterior pharynx so air can pass through and around the device. For adult patients, the two most widely used oropharyngeal airways are the Berman and the Guedel, each named for its designer. The Berman has channels along each side that allow a suction catheter or endotracheal tube to slide into the pharyngeal space. The Guedel is a tubular device. While its central lumen can be used for suctioning, it cant support an ET tube. Each oropharyngeal airway has three parts: the flange, the body, and the tip. When properly inserted, the flange is the piece that protrudes from the mouth and rests against the lips, preventing the device from sinking into the pharynx. The body follows the contour of the roof of the mouth, and will curve over and rest on top of the tongue. The distal end, or tip, sits at the base of the tongue. Steps youll take prior to insertion Before inserting an oral airway, make sure you select the appropriate size. Large adults require a size 5 - 6; medium adults require a size 4 - 5; and small adults need a size 3 - 4. To get the righ