1. Six Chapter Airway Management

4. Respiratory System

5. Breathing — Inhalation/Exhalation

12. P RECEPTOR P EARL Inform new EMT-Bs that a common sign of a partial airway obstruction is a snoring noise. As an experiment, they can simply hyperextend the neck of a snoring person (if they can do so without waking up the person) and listen as the snoring stops!

14. Child vs. Adult Airway

17. O PENING THE AIRWAY

18. Head-Tilt, Chin-Lift Maneuver

19. Jaw-Thrust Maneuver

20. T ECHNIQUES OF SUCTIONING

21. To remove blood, other liquids, and food from the airway. Purpose of Suctioning WHEN YOU HEAR GURGLING, SUCTION!

22. Mounted Oxygen-Powered Battery-Powered Manual Suction Types of Suction Units

24. Body Substance Isolation Equipment

25. Inspect and test suction unit before you need it.

26. Position the patient and yourself properly.

27. Open the patient’s mouth while protecting your fingers.

28. Without suctioning, insert hard catheter to base of tongue.

29. Once tip of catheter is in right place, apply suction, move tip, and remove fluid in airway.

30. If using a soft catheter, insert it only as far as the distance from the lips to the earlobe or angle of the jaw.

31. (Less in children and infants) Suction for No More Than 15 Seconds at a Time

33. If necessary, rinse catheter and tubing to prevent obstruction of tubing by dried material.

34. P RECEPTOR P EARL Rather than counting out 15 seconds as the maximum amount of time for suctioning, just take a breath and hold it as you begin to suction. When you need a breath, so does the patient. Stop suctioning and ventilate. In the excitement of a serious call, you will need to breathe more often than four times a minute!

35. T ECHNIQUES OF ARTIFICIAL VENTILATION

37. Mouth-to-Mask Ventilation

38. Bag-Valve Mask

39. Open the airway with the head-tilt, chin-lift technique.

40. Select mask of correct size.

41. Position yourself behind the patient’s head.

42. Hold the mask with your thumbs over the top half and your index and middle fingers over the bottom half.

43. Place the top of the mask over the patient’s nose and lower the bottom half of the mask over the mouth and chin.

44. If the mask has a large round cuff around the ventilation port, center the port over the patient’s mouth.

45. Use your ring and little fingers to lift the chin and maintain the head tilt.

46. Have an assistant squeeze the bag once every 5–6 seconds (3–5 seconds for a child or infant).

49. Using a Bag-Valve Mask When Trauma Is Suspected

51. Open airway and apply mask just as with bag-valve mask. Trigger device until chest rises. Repeat every 5–6 seconds.

55. Ventilating through a Stoma or Tracheotomy Tube Opening

56. Use a pediatric pocket mask to ventilate a patient with a stoma.

57. Aspiration of Stoma Aspiration of Tube (insert 3 – 5 inches) If unable to ventilate, suction.

59. A IRWAY ADJUNCTS

60. An oral airway can prevent the tongue from obstructing the airway of an unresponsive patient without a gag reflex.

61. Measure correct size. Open mouth and insert airway upside down.

62. When airway is in mouth as far as it will go, turn it right-side up. You can also insert an oral airway right side up, IF you use a tongue depressor to press the tongue down and forward.

63. NPA insertion: Choose correct size. Lubricate airway.

64. Insert the airway posteriorly. If it does not advance, try the other nostril.

65. O XYGEN ADMINISTRATION

67. Supplemental Oxygen How many liters are in the D, E, and jumbo D cylinders?

68. An Oxygen Delivery System

69. Position desired cylinder upright, stand to one side, and remove the wrapper.

70. If your system uses a replaceable washer, keep it, and crack the cylinder’s valve for 1 second.

71. Select appropriate regulator. Place washer on regulator and turn flowmeter to zero.

72. Align pins or thread by hand.

73. Tighten screw by hand or with a wrench.

74. Oxygen Delivery Devices

78. Explain procedures to patient and attach tubing to regulator.

79. Open valve, adjust flowmeter (fill bag of nonrebreather mask) . . .

80. . . . and place mask on patient.

81. Adjust flowmeter . . .

82. . . . and secure tank.

89. 1. What BSI procedures should be taken when doing airway techniques? 2. When should ventilations be assisted? 3. How and when are the OPA and NPA used? 4. How and when is suctioning provided? 5. When should oxygen be administered? R EVIEW QUESTIONS