Surgery Definition – How the Airway is managed in advanced traumatic life support?
Surgery Definition – How the Airway is managed in advanced traumatic life support?
The airway is managed by identifying the injuries which affect the airway severely. There are two forms of injuries which affect the airway. These include facial or neck trauma and head injury with low Glasgow Coma Scale and impaired the reflexes of the larynx or pharynx. Facial and neck trauma may include trauma to the face post assault, stab wound to the neck or the passenger who is unrestrained in head collision. As a result of facial or neck trauma, hematoma, bruising and oropharyngeal loose bodies may occur. Head injury with impairment of laryngeal or pharyngeal reflexes may present with Glasgow Coma Scale of 8 with impairment of the gag and cough reflexes. As a result, there will be inability to protect the airway with aspiration of the blood and vomit.
Airway need to be evaluated, by first taking a simple history from the patient. Any response which is lucid and in normal voice is considered as the present of intact airways with no compromise of the laryngeal airway.
If the patient is unresponsive, observe for any mist form in the oxygen mask, trauma to the face or blood and foreign bodies in the oropharynx. Look for any evidence of obstruction of the ventilatory system such as sea saw breathing (retraction of the abdomen on inspiration with no movement of the chest), tracheal tug and cyanosis as well as apnea.
Listen for any signs of cough reflex, movement of the air. Be cautious with the present of any airway obstruction which manifest in the form of stridor (due to extrathoracic large airway obstruction, hoarse inspiratory sound is heard), wheezing (due to intrathoracic small airway obstruction, expiratory sound is heard)
Feel the movement of the air or breath on your cheek. Assess the expansion and symmetry of the chest while inspecting the chest wall.
The basic steps of airway maneuvers may include head tilt, chin lift (only consider when there is no suspicion of C spine injury), jaw thrust and consider Yankaeur suction of any liquid or blood which obstruct the airway. Consider aiway adjunct if still unsuccessful.
The common airway adjunct may include angled forceps such as McGills forceps which is used to retrieve any foreign bodies which obstructing the airway, nasopharyngeal airway (should not be used in case of fracture of the basal skull or cribriform plate or trauma to the nose as it ma y increase of developing fasal passage and Guedel airway (oropharyngeal airway).
Endotracheal tube placement will definitely secure the airway.
The airway is managed by identifying the injuries which affect the airway severely. There are two forms of injuries which affect the airway. These include facial or neck trauma and head injury with low Glasgow Coma Scale and impaired the reflexes of the larynx or pharynx. Facial and neck trauma may include trauma to the face post assault, stab wound to the neck or the passenger who is unrestrained in head collision. As a result of facial or neck trauma, hematoma, bruising and oropharyngeal loose bodies may occur. Head injury with impairment of laryngeal or pharyngeal reflexes may present with Glasgow Coma Scale of 8 with impairment of the gag and cough reflexes. As a result, there will be inability to protect the airway with aspiration of the blood and vomit.
Airway need to be evaluated, by first taking a simple history from the patient. Any response which is lucid and in normal voice is considered as the present of intact airways with no compromise of the laryngeal airway.
If the patient is unresponsive, observe for any mist form in the oxygen mask, trauma to the face or blood and foreign bodies in the oropharynx. Look for any evidence of obstruction of the ventilatory system such as sea saw breathing (retraction of the abdomen on inspiration with no movement of the chest), tracheal tug and cyanosis as well as apnea.
Listen for any signs of cough reflex, movement of the air. Be cautious with the present of any airway obstruction which manifest in the form of stridor (due to extrathoracic large airway obstruction, hoarse inspiratory sound is heard), wheezing (due to intrathoracic small airway obstruction, expiratory sound is heard)
Feel the movement of the air or breath on your cheek. Assess the expansion and symmetry of the chest while inspecting the chest wall.
The basic steps of airway maneuvers may include head tilt, chin lift (only consider when there is no suspicion of C spine injury), jaw thrust and consider Yankaeur suction of any liquid or blood which obstruct the airway. Consider aiway adjunct if still unsuccessful.
The common airway adjunct may include angled forceps such as McGills forceps which is used to retrieve any foreign bodies which obstructing the airway, nasopharyngeal airway (should not be used in case of fracture of the basal skull or cribriform plate or trauma to the nose as it ma y increase of developing fasal passage and Guedel airway (oropharyngeal airway).
Endotracheal tube placement will definitely secure the airway.
