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OXYGENATION, AND
VENTILATION
PRIMARY SURVEY SECONDARY SURVEY
Airway : Airway :
Open the airway Provide advanced airway
management (tracheal
Breathing : intubation, LMA, combitube)
Provide positive- Breathing :
pressure ventilation Confirm proper tube
Circulation : placement by primary (px)
and secondary (exhaled CO2,
Give chest compressions esophageal detector device)
Defibrillation : methods, check fo adequate
oxygnation and ventilation
Shock VF / pulse less VT Circulation :
Obtain iv access
Continue CPR
Provide rhythm cv tx
Differential Diagnosis
OVERVIEW
Objectives and techniques of respiratory support
Primary A-airway
Provide supplementary O2
Ensure a patient and protected airway : use
manual technique as needed
Ensure a patient & protected airway : Use simple,
non invasive airway adjuncts
Primary B-Breathing
Monitor the quality of oxygenation and ventilation
with non-invasive devices
Provide positive pressure oxygenation and
ventilation with manual techniques or non
invasive airway
OVERVIEW
Secondary A-airway
Establish a patent and protected airway with
invasive advanced airway devices
Confirm proper placement of these devices with
primary and secondary confirmation techniques
Secondary B-Breathing
Provide effective positive-pressure oxygenation
and ventilation using advance and airway devices
Secure the advance airway devices to prevent
displacement
Monitor oxygenation and ventilation
If the patient is
making spontaneous
breathing efforts, is
there evidence of
partial or complete
airway obstruction?
If spontaneous breathing is present,
patients is unconscious provide in
recovery position
PROVIDE SUPPLEMENTARY OXYGEN
WITH AIRWAY ADJUNCTS
Overview
The unconscious pt with spontaneous
heart beat and compromised oxygenation
an ventilation
HEAD TILT CHIN LIFT
JAW THRUST
MAINTAIN A PATENT AIRWAY
USING AIRWAY ADJUNCTS
Oropharingeal airways
Nasopharingeal airways
Oropharyngeal airway
Holds the tongue away from
the posterior wall of the
pharynx
Facilitates suctioning of the
pharynx
Prevents the pt. from biting
and occluding a tracheal tube
Unconscious pt. with
spontaneously breathing
without gag reflex
Oropharyngeal airway
Complications :
Complete airway obstruction
Laringospasm
Vomiting
Oropharyngeal airway
insertion
Nasopharyngeal airway
The patients is spontaneously breathing,
have an intact cough and gag reflex
Nasopharyngeal Airway
Complications
Nasal mucosa injury
Laryngospasm
Nasopharyngeal Airway
Techniques
PROVIDE VENTILATION WITH
Indications
- Inability of the rescuer
to ventilate the
unconscious pt w/
less invasive methods
- Inability of the pts to
protect their airway
- Prolong need for
chest compression
during cpr
Ventilation and oxygenation must be provided
initially before laryngoscopy and tracheal
intubation attempts
Complications
Trauma
Vomiting and
aspiration
Main bronchus
intubation
Eshopageal
intubation
Reflex sympathetic
and para sympathetic
stimulation
Preventing complications of
tracheal intubation
Properly trained personnel
Limit intubation attempts to
20-30 s
RSI sequence (w/
premedication, sedation &
paralysis
A high-volume, low pressure
cuff tube
TECHNIQUE
In CPR, pt w/ tracheal
intubation :
VENTILATION
RESCUES should not
SYNCHRONIZED with
CHEST
COMPRESSION
ALTERNATIVE ADVANCED
AIRWAYS