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Airway Obstruction and i= ts Relief <= /span>
Module 3 in a Slide Series = on Clinical Airway Management
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Airway Obstruction
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go0xf3zk5D65fim+c6SWJ+Y/B/qTscKK8yD2qN7NLV4Vc/T35lXLQYc6xnk+dapH3epXL/nSqb51 vC4c61+HudNRznWKex3sZwf7dtVenqbrlrvZRnvc5d6bi8/d7nfP0trhjne+993vfwd84AU/+IAA ADs= ------=_NextPart_01C86A49.B6EC5E80 Content-Location: file:///C:/706BB24E/AirwayObstruction_files/slide0003.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="windows-1252" Module 13
Partial Airway Obstruction
•  
•   Partial airway obstructi= on may be mild, as in snoring or nasal congestion, or <= /span>may be more severe, perhaps requiring the use of airway adjuncts such as a nasopharyngeal airway.
•  
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 Complete Airway Obstructi= on
•  
•   Complete airway obstruct= ion is usually managed by prompt intubation, but surgical airways are sometimes needed as a last resort when neither intubation = nor ventilation is possible.
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Possible Signs of Airway Obstruction
<= span style=3D'font-size:88%'>•Chest / abdominal movements not coordinated = ;
•Abnormal capnogram
•Chest does not rise  well
•“Crowing”  (expiratory stridor]
•Distressed patient
•“Tracheal tug= ”  -  trachea moves posteriorally with inspiration
•Use of accessory muscles of respiration
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Many Causes for Obstruction
•
•   Obstructed breathing can= occur with snoring, with sleep apnea syndromes, or following muscle relaxation of any kind (e.g. general anaesthesia with or without neuromuscular blocking agents).
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More Causes of
  Airway Obstruct= ion
•   Airway obstruction can also occur with infection (e.g. epiglottitis), tumors, hematomas following surgery, fr= om aspirated foreign bodies (e.g. pean= ut lodged in glottic orifice) or even = with vocal cord pathology (bilateral RLN damage).
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Management of
Airway Obstruction
= •   = Management of airway obstruction depends on the clinical particulars, and is managed by one or more of: treating the root cause, repositioning the patient’s jaw (jaw thrust maneuver), putting the patient in = the recovery position, using an airway adj= unct (e.g. oropharyngeal airway), intubating the patient, or even by establishing a = surgical airway (in drastic circumstances).
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Posterior Displacement o= f Tongue and Soft Palate=
•   Commonly, obstruction occurs, at least in part, when the tongue base falls back posteriorly to obstruct the oropharynx.
•
•   Movement of the soft pal= ate may also contribute to airway obstruction. <= /span>
•
• An oropharyngeal airway often helps.
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Head Tilt / Jaw Thrust
3Dhtilt
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Airway Adju= ncts
•   Airway adjuncts are often helpful in reducing airway obstruction  in spontaneously breathing patients.  These include oropharyngeal airways (usually = adult sizes 8, 9, 10), nasopharyngeal= airways (“nasal trumpets” inserted into one or both nostrils) or the laryngeal mask= airway (LMA).
•
------=_NextPart_01C86A49.B6EC5E80 Content-Location: file:///C:/706BB24E/AirwayObstruction_files/slide0012.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="windows-1252" Module 13
Oropharyngeal Airway
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Oropharyngeal Air= way
•   Use of an oropharyngeal airway can help maintain a clear airway in anesthetized or sedated patients breathing spontaneously.
•
•             
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Oropharyngeal Air= way
• Use a size 8, 9,10 for small, regular and large patients respectively. •  
Insertion in patients at light planes o= f anesthesia can sometimes result in laryngospasm.
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3D"nasopharyngeal_airwayHR"
Nasopharyngeal Airway
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  Nasal Trumpets
•   Nasal airways (nasal trumpets) are often used in patients with some degree of airway obstruction where an oral airway might not be well-tolerated.
•
• Use a size 6.5, 7.0 or 7.5 in adults.
•
• Bilateral trumpets are sometimes used.
3D"nasopharyngeal_airwayHR"
------=_NextPart_01C86A49.B6EC5E80 Content-Location: file:///C:/706BB24E/AirwayObstruction_files/slide0017.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="windows-1252" Module 13
Laryn= geal Mask Airway (LMA)
3Dintrav2
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