CVS Respiratory Practicals Biomedical Summary 2009

Emergency Medical Care : 

Emergency Medical Care Module: Emergency Airway Management Lecturer: Mr Robin Heneke Module: Emergency Airway Mx. Oxygenation and Ventilation Topics: - Airway Algorithms Cape Peninsula University of Technology Faculty of Health and Wellness Sciences Department of Emergency Medical Sciences

What degree of intervention is required? : 

What degree of intervention is required?

Emergency Airway Management: : 

Emergency Airway Management: Cape Peninsula University of Technology Faculty of Health and Wellness Sciences Department of Emergency Medical Sciences How would you manage the Airway in this scenario? Buzz for five minutes and discuss the management of this scenario.

How would you manage the airway? : 

How would you manage the airway?

Slide 5: 

No No No No Yes Yes Yes Yes Yes No No Yes Yes Yes The Decision to Intubate Prehospital Algorithm

Airway Assessment and: The Decision to Intubate : 

Airway Assessment and: The Decision to Intubate Cape Peninsula University of Technology Faculty of Health and Wellness Sciences Department of Emergency Medical Sciences Is there a failure of airway maintenance or protection? Is there a failure of ventilation or oxygenation? What is the anticipated clinical course?

Emergency Airway Management – Key Questions: : 

Emergency Airway Management – Key Questions: Cape Peninsula University of Technology Faculty of Health and Wellness Sciences Department of Emergency Medical Sciences Why use: Emergency Airway Algorithms

Develop a Scene / Airway management strategy: : 

Develop a Scene / Airway management strategy: Cape Peninsula University of Technology Faculty of Health and Wellness Sciences Department of Emergency Medical Sciences Prehospital Airway Management Protocol / Algorithm Criteria for the Algorithm: Guide that when utilized for different patients gives reproducible results Protocol / Algorithm is dynamic in nature…guided by scientific evidence User friendly and a natural part of every patient care scenario!

Slide 9: 

Yes Yes Yes Yes No No No No No Yes Ref. Manual of Emergency Airway Management, R.M Walls 3rd Ed. The Main Airway Management Algorithm

CRASH AIRWAY ALGORITHM : 

Yes Yes Yes No No No CRASH AIRWAY ALGORITHM Yes No Yes No Ref. Manual of Emergency Airway Management, R.M Walls 3rd Ed.

CRASH AIRWAY : 

Yes Yes No No No No Questions: Is the patient completely unresponsive (A.V.P.U). Criteria: Full Cardio / Respiratory arrest OR Only Agonal Cardio-respiratory activity e.g. Agonal or ineffective respirations 6<min Pulseless Idioventricular rhythm 26 b/min Peri-arrest situations CRASH AIRWAY

Slide 12: 

Yes Yes Yes Yes No No No No No Yes Ref. Manual of Emergency Airway Management, R.M Walls 3rd Ed. The Main Airway Management Algorithm

DIFFICULTAIRWAY ALGORITHM : 

Yes Yes No No No DIFFICULTAIRWAY ALGORITHM Yes No Unsuccessful By definition: A Difficult Airway is something one anticipated! A Failed Airway is something one experiences! Four dimensions: 1 – Difficult Bag/Mask ventilations (MOANS) 2 – Difficult Laryngoscopy & Intubation (LEMON) 3 – Difficult Extraglottic Device (RODS) 4 – Difficult Cricothyrotomy (SHORT)

Slide 14: 

Yes Yes Yes Yes No No No No No Yes Ref. Manual of Emergency Airway Management, R.M Walls 3rd Ed. The Main Airway Management Algorithm

FAILED AIRWAY ALGORITHM : 

No Yes Yes FAILED AIRWAY ALGORITHM No If contra-indicated Note: Extra-glottic device may be attempted while preparing for Cricothyrotomy Ref. Manual of Emergency Airway Management, R.M Walls 3rd Ed.

FAILED AIRWAY ALGORITHM : 

Yes No FAILED AIRWAY ALGORITHM Yes If contra-indicated No Definition/criteria: Has there been a failure of intubation attempts in a patient for whom oxygenation cannot be adequately maintained by BVM, OR Has there been three unsuccessful attempts by an experienced operator? Key goal: Provide sufficient emergency oxygenation to prevent morbidity!

Slide 17: 

EMC 2009 CORE AIRWAY MANAGEMENT ALGORITHM No No Yes Yes Fail Fails Fails Ref. Manual of Emergency Airway Management, Walls / Murphy 3rd Ed.