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1、Airway Do not warmAttach BAAM (if available)Airway & Ventilation Methods: ALSBlind Nasotracheal Intubation (cont)Position patient (preferably sitting upright)Insert tube into largest nareAdvance slowly but steadilyListen for sound of whistle via BAAMAdvance tubeInflate cuff & Assess placementSecure
2、& ReassessAirway & Ventilation Methods: ALS Digital IntubationBlind technique Variable probability of successUsing middle fingers to locate epiglottisLift epiglottisSlide lubricated tube along side fingersAssess tube placement & depth as with orotracheal intubationAirway & Ventilation Methods: ALS D
3、igital IntubationFrom AMLS, NAEMTAirway & Ventilation Methods: ALSSurgical CricothyrotomyIndicationsabsolute need for a definitive airway ANDunable to perform ETT due for structural or anatomic reasons, ANDrisk of not intubating is than surgical airway riskORabsolute need for a definitive airway AND
4、unable to clear an upper airway obstruction, ANDmultiple unsuccessful attempts at ETT, ANDother methods of ventilation do not allow for effective ventilation and respirationAirway & Ventilation Methods: ALSSurgical CricothyrotomyContraindications (relative)No real demonstrated indicationRisks benefi
5、tsAge 8 years (some say 10)evidence of fx larynx or cricoid cartilageevidence of tracheal transectionAirway & Ventilation Methods: ALSSurgical CricothyrotomyTipsKnow your anatomyShort incision, avoid inferior tracheaIncise, Do not sawWork quickly. Have a planBe prepared with a backup planAirway & Ventilation Methods: ALSNeedle Cricothyrotomy & Transtracheal Jet VentilationIndicationsSame as surgical cricothyrotomy along withContraindication for surgical cricothyrotomyContraindicationsNone when demonstrated needcaution with tracheal transection
