AIRWAY MANAGEMENT

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AIRWAY MANAGEMENT: 

AIRWAY MANAGEMENT Dr. Shaik Nawaz Ahmed Assistant professor Dept. of anaesthesia RIMS ,kadapa

TOPICS: 

TOPICS Anatomy of airway. Airway equipment. Endotracheal intubation.

Anatomy of airway: 

Anatomy of airway Airway in humans is divided into 1) upper respiratory tract :- Nose to vocal cords. 2) lower respiratory tract :- Below vocal cords

PowerPoint Presentation: 

Upper respiratory tract lower respiratory tract

UPPER RESPIRATORY TRACT: 

UPPER RESPIRATORY TRACT

UPPER RESPIRATORY TRACT: 

UPPER RESPIRATORY TRACT Three parts: 1) Nasal cavity. 2) Pharynx: 3parts a) naso-pharnx . b) oro -pharynx. c) laryngo -pharynx. 3) Larynx

PowerPoint Presentation: 

Selicks manouvre

VOCAL CORDS: 

VOCAL CORDS

AIRWAY EQUIPMENT: 

AIRWAY EQUIPMENT AMBU bag Airways – guedel airway, naso -pharyngeal airway. Larygoscope . Endotracheal tube. Stylet . Bougie .

AMBU bag: 

AMBU bag Artificial Manual breathing Unit. It is also known as a Bag valve mask. AMBU is a hand-held device used to provide positive pressure ventilation to a patient who is not breathing or who is breathing inadequately.

Parts of Ambu bag: 

Parts of Ambu bag

AMBU bag: 

AMBU bag Sizes: Bag Adult------1600 ml. Child-------500 ml. Infant-------500 ml. Mask Adult------Size 4 Child------Size 2 Infant------Size 1 Reservoir Adult------suitable for 1600 ml. bag Child / Infant---Suitable for 500 ml. bag

Technique to use AMBU bag: 

Technique to use AMBU bag

Technique to use AMBU bag: 

Technique to use AMBU bag

Guedel airway: 

Guedel airway A curved piece of plastic inserted over the tongue that creates an air passage way between the mouth and the posterior pharyngeal wall. Indications Oropharyngeal Airways are designed to maintain an unobstructed Oro- Pharyngeal airway. Integral hard bite block avoids airway occlusion and biting of the tongue.

Parts of guedels airway: 

Parts of guedels airway

Color Code: 

Color Code

Size selection: 

Size selection

Insertion procedure: 

Insertion procedure

NASO-PHARYNGEAL AIRWAY: 

NASO-PHARYNGEAL AIRWAY Useful when patient is not tolerating oral airway. Prevent airway obstruction by tongue fall.

NASO-PHARYNGEAL AIRWAY: 

NASO-PHARYNGEAL AIRWAY

LARYNGOSCOPE: 

LARYNGOSCOPE An instrument to facilitate direct laryngoscopy . It helps in intubation into trachea of patient in emergency as well as during anaesthesia. Two parts: 1) handle. 2) blade.

PARTS OF BLADE: 

PARTS OF BLADE BULB TONGUE FLANGE

TYPES OF BLADE: 

TYPES OF BLADE MILLER MACINTOSH

McKOY BLADE: 

McKOY BLADE MOVABLE TIP

ENDOTRACHEAL TUBE: 

ENDOTRACHEAL TUBE provides a passage for gases to flow between a patients lungs and an anaesthesia breathing system . allows one to provide positive pressure ventilation. protects the lung from contamination from gastric  contents and nasopharyngeal matter such as blood.

Parts of ET tube: 

Parts of ET tube Pilot tubing Pilot balloon Murphy’s eye cuff 15mm connector

Parts of ET tube: 

Parts of ET tube

Markings on ET tube: 

Markings on ET tube

Markings on ET tube: 

Markings on ET tube

TYPES OF ENDOTRACHEAL TUBE: 

TYPES OF ENDOTRACHEAL TUBE oral or nasal, PVC or Red rubber cuffed or uncuffed , preformed (e.g. RAE tube), reinforced tubes, and double-lumen endobronchial tubes

oral / nasal ETT: 

oral / nasal ETT Shoter Bevel angle less

oral / nasal ETT: 

oral / nasal ETT

Red rubber/ PVC ET tubes: 

Red rubber/ PVC ET tubes

Red rubber/ PVC ET tubes: 

Red rubber/ PVC ET tubes

cuffed /uncuffed ET tubes: 

cuffed / uncuffed ET tubes

Preformed (e.g. RAE tube): 

Preformed (e.g. RAE tube)

Reinforced tubes: 

Reinforced tubes

BOUGIE: 

BOUGIE

STYLET: 

STYLET

INTUBATION KIT: 

INTUBATION KIT

Endotracheal intubation: 

Endotracheal intubation Selicks maneuver Succinyl choline

Airway assessment: 

Airway assessment

Mallampati Score: 

Mallampati Score The Mallampati score is a simple grading system evaluating the size of the base of the tongue, which is felt to be an important factor determining the degree of difficulty in direct laryngoscopy

3-3-2 rule: 

3-3-2 rule 3 fingers Mouth opening Chin to hyoid Thyroid cartilage and floor of mouth 3 fingers 2 fingers

Risk Index of El-Ganzouri for Difficult Tracheal Intubation : 

Risk Index of El- Ganzouri for Difficult Tracheal Intubation Variable Finding Points mouth opening ≥ 4 cm 0 < 4 cm 1 thyromental distance > 6.5 cm 0 6.0−6.5 cm 1 < 6.0 cm 2 Mallampati score I 0 II 1 III 2

Risk Index of El-Ganzouri for Difficult Tracheal Intubation : 

Variable Finding Points neck movement > 90° 0 80−90° 1 < 80° 2 ability to prognath yes 0 no 1 body weight < 90 kilograms 0 90−110 kilograms 1 >110 kilograms 2 history of difficult intubation none 0 questionable 1 definite 2 Risk Index of El- Ganzouri for Difficult Tracheal Intubation

Risk Index of El-Ganzouri for Difficult Tracheal Intubation : 

Interpretation: minimum score: 0 maximum score: 12 Index Score Tracheal Intubation < 4 unlikely to be difficult ≥ 4 likely will be difficult Risk Index of El- Ganzouri for Difficult Tracheal Intubation

Grade 1 view of vocal cords: 

Grade 1 view of vocal cords

Direct laryngoscopy view : 

Direct laryngoscopy view

Cormack and Lehane grading of difficult intubation: 

Cormack and Lehane grading of difficult intubation

Cook modification: 

Cook modification

Technique of intubation: 

Technique of intubation

PowerPoint Presentation: 

Technique of intubation

PowerPoint Presentation: 

Technique of intubation POPITZ pillow

PowerPoint Presentation: 

Technique of intubation

Bogie intubation: 

Bogie intubation

PowerPoint Presentation: 

Thank you