A Review of Basic Airway Management: a Moulage

Professor Richard Williams OBE TD

Learning objectives

By the end of this session, attendees should have revised their knowledge of basic airway management techniques

The ATLS principlePrevention of hypoxemia requires a protected, unobstructed airway and adequate ventilation, which take priority over management of all other conditions

Airway AssessmentAssessing the adequacy of the airway • Patient is alert & oriented• Patient is talking normally• There is no evidence of injury to the head or neck• Assess & reassess to detect deterioration

Airway Assessment

Signs and symptoms of airway compromise• Change in voice / sore throat• Noisy breathing (snoring and stridor)• Dyspnea and agitation• Tachypnea• Abnormal breathing pattern• Low oxygen saturation (late sign)

Airway Management 1Managing the airways of injured patients• C Spine immobilisation• Assess the airway

• Look, listen and feel• Give additional oxygen• Basic airway opening techniques• Basic adjuncts

• Nasopharyngeal airway• Oropharyngeal airway

• Definitive airway• Is having a cuffed tube in the trachea

• Endotracheal intubation• Surgical airway

Airway Management 2A definitive airway is a tube placed in the trachea with the cuff inflated below the vocal cords, the tube connected to some form of oxygen-enriched assisted ventilation, and the airway secured in place with tape

Summary● Suspect airway compromise in all injured patients

and protect the cervical spine● Be prepared for easy and difficult airway● Consider adjuncts for establishing a patent airway● Definitive airway is a cuffed tube in the trachea● Quickly assess the patency and adequacy of

ventilation using a pulse oximeter and end-tidal CO2