文档介绍：会计学
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呼吸道通气方法ALS3
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Airway & Ventilation Methods: ALS
Straight (Miller) Blade
Visualize anatomy
Insert from right to left moving tongue away
Lift upward and away
Blade past vallecula and over epiglottis
Lift epiglottis directly
From AHA ACLS
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Tube Positioning
From TRIPP, CPEM
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Airway & Ventilation Methods: ALS
Blind Nasotracheal Intubation
Position & Oxygenate patient
Monitor patient
ECG Monitor
Pulse oximeter
Assess for BNI difficulty or contraindication
Assemble & check equipment
Lubricate end of tube; Do not warm
Attach BAAM (if available)
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Airway & Ventilation Methods: ALS
Blind Nasotracheal Intubation (cont)
Position patient (preferably sitting upright)
Insert tube into largest nare
Advance slowly but steadily
Listen for sound of whistle via BAAM
Advance tube
Inflate cuff & Assess placement
Secure & Reassess
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Airway & Ventilation Methods: ALS
Digital Intubation
Blind technique
Variable probability of success
Using middle fingers to locate epiglottis
Lift epiglottis
Slide lubricated tube along side fingers
Assess tube placement & depth as with orotracheal intubation
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Airway & Ventilation Methods: ALS
Digital Intubation
From AMLS, NAEMT
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Airway & Ventilation Methods: ALS
Surgical Cricothyrotomy
Indications
absolute need for a definitive airway AND
unable to perform ETT due for structural or anatomic reasons, AND
risk of not intubating is > than surgical airway risk
OR
absolute need for a definitive airway AND
unable to clear an upper airway obstruction, AND
multiple unsuccessful attempts at ETT, AND
other methods of ventilation do not allow for effective ventilation and respiration
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Airway & Ventilation Methods: ALS
Surgical Cricothyrotomy
Contraindications (relative)
No real demonstrated indication
Risks > benefits
Age < 8 years (some say 10)
evidence of fx larynx or cricoid cartilage