Airway_Management Powerpoint Lecture Modern

airway mgmnt

1. Airway Management Lecture Summary – Modern Critical Care Focus

2. Learning Objectives Recognize signs of airway obstruction Understand basic and advanced airway techniques Master BVM, adjuncts, and intubation basics Know rescue options for a failed airway Maintain oxygenation and prevent complications

3. Airway Anatomy Overview Upper airway: nose, mouth, pharynx, larynx Lower airway: trachea, bronchi, lungs Key landmarks: epiglottis, vocal cords, cricoid cartilage Understand structures to anticipate challenges

4. Airway Assessment Look for obstruction: stridor, snoring, gurgling Assess consciousness and ability to protect airway Predict difficulty (LEMON): Look, Evaluate 3-3-2, Mallampati, Obstruction, Neck mobility Plan for backup early

5. Basic Airway Maneuvers Head tilt–chin lift (no cervical injury) Jaw thrust (suspected C-spine injury) Avoid neck extension in unstable spine Use suction to clear blood or secretions

6. Airway Adjuncts Oropharyngeal airway (OPA): for unresponsive, no gag reflex Nasopharyngeal airway (NPA): for semiconscious, avoid if basilar skull fracture Proper sizing critical for effectiveness Adjuncts bridge to definitive airway

7. Bag-Valve-Mask (BVM) Ventilation Essential rescue skill – cornerstone of airway support Ensure good mask seal (E-C clamp technique) Deliver visible chest rise; avoid over-ventilation Two-person technique preferred Rate: 1 breath every 5–6 seconds

8. Endotracheal Intubation Overview Indications: failure to oxygenate/ventilate or protect airway Use preoxygenation (100% O₂ for 3–5 min) Rapid sequence induction (RSI) in most ICU/ER settings Confirm placement: end-tidal CO₂, chest rise, auscultation

9. Predicting a Difficult Airway Limited mouth opening or neck mobility Obesity, facial trauma, airway swelling Short thyromental distance (<6 cm) Use difficult airway algorithm; have rescue plan ready

10. Rescue & Extraglottic Devices Laryngeal Mask Airway (LMA), i-gel, King LT as bridges Rapid to insert, useful when intubation fails Not full aspiration protection Confirm placement and ventilation adequacy

11. Failed Airway Strategy Recognize early: cannot intubate, cannot ventilate Call for help, use alternative airway device Consider cricothyrotomy if all else fails Always maintain oxygenation as the priority

12. Cricothyrotomy Indication: emergent airway when others fail Identify cricothyroid membrane between thyroid & cricoid cartilages Use scalpel-bougie-tube technique Complications: bleeding, misplacement, subglottic stenosis

13. Oxygenation & Monitoring Use supplemental O₂ for all airway interventions Target SpO₂ ≥ 90% (PaO₂ > 60 mmHg) Continuous pulse oximetry & capnography Beware motion artifact and poor perfusion effects

14. Complications & Prevention Aspiration, esophageal intubation, airway trauma Dental injury, hypoxia, bradycardia during attempts Preoxygenate, limit attempts to <30 sec Reassess after every intervention

15. Post-Intubation Management Confirm and secure tube at appropriate depth Adjust ventilator settings for adequate oxygenation/ventilation Monitor vital signs and waveform capnography Sedation and analgesia as needed

16. Key Takeaways Always assess, anticipate, and prepare for difficulty Prioritize oxygenation over intubation success Use stepwise escalation with backup devices Training and teamwork are essential Stay calm, deliberate, and systematic

17. Questions Thank you for your attention. Discussion and case reviews welcome.