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Professional development

&Skill's Lab (III)

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I- Bag Mask VentilationII- Chest AuscultationIII- Head TiltIV- Jaw ThrustV- Heart AuscultationVI- Orophryngeal Airway Insertion

CONTENTS

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AP = Adequately Performed

IP = Inadequately Performed

NP = Not Performed

STEP/TASK AP IP NP

Inspecting the victim:Bag-valve mask ventilation

1. Choose an appropriately sized bag-valve mask2. Attach the bag-valve mask to an oxygen supply if present.3. Hold the mask over the face with your hand. Place your thumb

over the mask near the nose and support the jaw with the middle

and ring fingers, ensuring a tight seal (C&E)

4. Use your free hand to compress the bag5. Ventilate with the bag at a rate of 10 compression per minute6. Look for a rise in the chest.

.

Clinical Learning Guide

Ambu bag ventilation

Bag-valve mask ventilation

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Auscultation of the chest

Ask the patient to take deep breaths through the mouth.

Using the diaphragm of the stethoscope, auscultate the chest. Start at the apex of one lung, and compare one side to the other. Normal breath sounds are made of 2 sounds: an inspiratory sound

followed immediately without a pause by an expiratory sound

The inspiratory phase is normally longer and louder The expiratory phase is much shorter and fainter

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AP = Adequately Performed

IP = Inadequately Performed

NP = Not Performed

Clinical Learning Guide

Head tilt/chin lift

STEP/TASK AP IP NP

Inspecting the victim:Start Head tilt-Chin lift maneuver

1. Place your hand on his forehead and gently tilt his head back.2. With your fingertips of the other hand, under the point of his chin,

lift the chin to open the airway.

3. Holding his airway open put your ear to his mouth. Listen, feel, and

lookfor breathing for no more than 10 seconds.

Head tilt-Chin lift

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AP = Adequately Performed

IP = Inadequately Performed

NP = Not Performed

Clinical Learning Guide

Jaw thrust

STEP/TASK AP IP NP

Inspecting the victim:Application of Jaw Thrust Maneuver.If spine injury is doubtful

1. Apply both hands fingertips' to the angles of the mandibles onboth sides..

2. Apply both thumbs on the chin keeping the mouth open.3. Then listen, feel and look to the breathing movements and sound of

the patient.

Head tilt-Chin liftJaw-thrust

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Auscultation of the heart

o Listen for heart sounds, additional sounds, murmurs, and pericardial rub. Using the

stethoscope's diaphragm, listen in the:

oAortic area

Right second intercostal space near the sternum.

oPulmonary areaLeft second intercostal space near the sternum.

o Tricuspid areaLeft third, fourth, and fifth intercostal spaces near the sternum.

Mitral arealeft fifth intercostal space, in mid clavicular line

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AP = Adequately Performed

IP = Inadequately PerformedNP = Not Performed

Oropharyngeal airway

Clinical Learning Guide

Orophryngeal airway insertion

STEP/TASK AP IP NP

Inspecting the victim:Oropharyngeal airway insertion

1. Identify the need for a Guedel airway (e.g. if the airway isobstructed or the patient is unconscious).

2. Size the Guedel airway by measuring the distance from theincisors to the angle of the jaw. The most commonly used sizes are

2 for a small adult, 3 for a medium adult and 4 for a large adult.

3. Insert the Guedel airway so that its concave side faces away fromthe tongue.

4. Insert the airway into the mouth to approximately one-third of itslength. Whilst gently pushing the airway further in, rotate it 180

and slide it in to its full extent.

5. Check for breathing.