Related Subjects:
|Airway Obstruction
|Surgical Cricothyroidotomy
|Rapid Sequence Induction
First step of resuscitation is to ensure airway intact
About
- Sudden onset: Foreign body aspiration, anaphylaxis
- Slow onset: malignancy, inflammatory
- Wheeze: expiratory
- Stridor: Inspiratory
Anatomy
Causes
- Luminal
- Dentures, food bolus in mouth e.g. steak
- Facial fractures e.g. Fractured mandible
- Enlarged tongue - angioedema with alteplase, bleeding into tongue
- Foreign body
- Tumour - laryngeal cancer, lung cancer
- Haemorrhage
- Mucus plugs
- Trauma to airway
- Bilateral vocal cord palsy
Mural
- Oedema: Local Trauma or Anaphylaxis
- Haemorrhage and haematoma: trauma, post Thyroid op
- Pus: Abscess, Epiglottitis
- Enlarged tonsils
- Laryngeal stenosis
- Laryngeal oedema
- Laryngospasm
- Bronchospasm - asthma and mucus plugs
- Outside the airway
- Retropharyngeal abscess
- Large goitre
- Obesity
- Anaphylaxis
- Haemorrhage around neck
Clinical
- Respiratory distress
- Cyanosis, shock
- Respiratory arrest
Head tilt and chin lift
Adjuncts:Nasopharyngeal airway
Adjuncts:Guedel airway
Adjuncts:Considering Front of Neck Airway
Management
- Luminal obstruction suspected: Finger sweep if suspected intraluminal obstruction. Leave dentures in place.
- Choking algorithm: If still standing and choking try Hitting in back and then Heimlich manoeuvre. This is used to expel an inhaled foreign body. Stand behind the patient. Encircle the upper part of the abdomen, just below the patient’s rib cage, with your arms. Give a sharp, forceful squeeze, forcing the diaphragm sharply into the thorax.
- Anaphylaxis algorithm if appropriate. IV access. IM Adrenaline 0.5 mg IM
- Unconscious breathing and pulse. If not breathing start CPR
- Ensure chin lift and jaw thrust and inspect mouth and oropharynx
- Give high flow Oxygen. Recovery position and monitor
- Consider Guedel and/or nasopharyngeal airways
- Failing to oxygenate
- Manually ventilate with ambu bag and 100% Oxygen
- Prepare to intubate and ventilate