Are you aware on proper handling and usage of Bag mask valves?
How do you identify between normal and inadequate breathing?
Can you apply your tourniquet during emergencies?
Assessing medical and trauma patients is very delicate and as medical
professional we must be trained for effiiciency.
Consider this scenario: You’re intubating a patient who has bad pneumonia
and likely Acute Respiratory Distress Syndrome.The patient is on BIPAP
(a non-invasive ventilation method used to support breathing by delivering
pressurized air to keep the airways open and improve oxygenation) and is
being pre oxygenated. Saturattion level is 94% despite receiving 100%
fraction of inspired oxygen (FiO2), the patient’s oxygen saturation is only 94%,
which indicates that the lungs are severely compromised.
You position appropriately and do all steps for high first pass success.
You get a view but the tube falls on the flloor!
“What do you do to improve the situation?”
Below, you will see our AMLS instructor providing the head-lift, chin -up maneuvre
with CE Clamps to ensure correct placement. This action aligns the airway and
helps prevent the soft tissues from obstructing it, improving airflow thereby ensuring the delivery of quality oxygen.
Ensure a proper seal using the CE clamp technique and deliver ventilations at a rate of
10-12 breaths per minute for adults, and 12-20 breaths per minute for children.
Procedures for Ensuring Proper Airway Management
Initial Assessment:
Check Responsiveness: Assess the patient’s level of consciousness.
Open the Airway: Use the chin lift-head tilt maneuver or jaw thrust if cervical spine injury is suspected.
Look, Listen, and Feel: Check for breathing by looking for chest rise, listening for breath sounds,
and feeling for airflow.
Observe Chest Rise: Ensure each ventilation results in visible chest rise.
Avoid excessive ventilation to prevent gastric inflation.
Airway Clearance:
Suctioning: Remove any visible obstructions, vomit, or secretions using suction.
Airway Adjuncts: Use oropharyngeal (OPA) or nasopharyngeal airway (NPA) adjuncts
if needed to maintain airway patency.
In conclusion, for the quesion above, you can place an oral airway to avert obstruction
by tongue or other soft tissues, immediately deploy head lift ,chin up technique, continue
bag mask ventilation with a PEEP valve while a Respiratory Therapist gets a spare tube
and hands it over. Gets saturations above 90 or more.
Once patient is stabilized and their oxygen levels are sufficient, proceed with the intubation
to secure the airway for more controlled and effective ventilation.
Soneye Segun
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