《airwaymanagement,ventilation,oxygentherapy：气道管理，通风，氧疗》由会员分享，可在线阅读，更多相关《airwaymanagement,ventilation,oxygentherapy：气道管理，通风，氧疗（85页珍藏版）》请在金锄头文库上搜索。
1、Kansas Airway Supplement,1,Unlocking airway management skills .,the key to patient survival.,Kansas Airway Supplement Kansas BEMS EMS Educator Task Force,2,Respiratory Anatomy,Nose and mouth (warms, moistens, and filters air). Pharynx Oropharynx Nasopharynx Epiglottis Trachea (windpipe),Kansas Airwa
2、y Supplement Kansas BEMS EMS Educator Task Force,3,Upper Airway,Tongue,Glottis,Epiglottis,Kansas Airway Supplement Kansas BEMS EMS Educator Task Force,4,Respiratory Anatomy,Cricoid cartilage Larynx (voice box). Bronchi Lungs Visceral pleura (surface of lungs) Parietal pleura (internal chest wall) In
3、terpleural space (potential space),Kansas Airway Supplement Kansas BEMS EMS Educator Task Force,5,Lower Airway,Kansas Airway Supplement Kansas BEMS EMS Educator Task Force,6,Respiratory Anatomy,Diaphragm Inhalation (active process) Diaphragm and intercostal muscles contract, increasing the size of t
4、he thoracic cavity. Diaphragm moves slightly downward, ribs move upward and outward. The negative pressure in the chest cavity causes air flow into the lungs.,Kansas Airway Supplement Kansas BEMS EMS Educator Task Force,7,Respiratory Anatomy,Exhalation (passive process) Diaphragm and intercostal mus
5、cles relax decreasing the size of the thoracic cavity. Diaphragm moves upward, ribs move downward and inward. The positive pressure inside the chest cavity causes air flow out of the lungs.,Kansas Airway Supplement Kansas BEMS EMS Educator Task Force,8,Anatomical sources of ventilation problems,Uppe
6、r airway Lower airway Head/neck-Brain Spinal cord Chest wall,Kansas Airway Supplement Kansas BEMS EMS Educator Task Force,9,Respiratory Physiology,Oxygenation - blood and the cells become saturated with oxygen Hypoxia - inadequate oxygen levels in the blood Signs of Hypoxia Increased or decreased he
7、art rate Altered mental status (early sign) Agitation Initial elevation of B.P. followed by a decrease Cyanosis (often a late sign),Kansas Airway Supplement Kansas BEMS EMS Educator Task Force,10,Alveolar Gas Exchange,Oxygen-rich air enters the alveoli during each inspiration. Oxygen enters the bloo
8、d in the capillaries as carbon dioxide enters the alveoli for exhalation.,Kansas Airway Supplement Kansas BEMS EMS Educator Task Force,11,Infant and Child Considerations,Mouth and nose - generally all structures are smaller and more easily obstructed than in adults. Pharynx - infants and childrens t
9、ongues take up proportionally more space in the mouth than adults. Trachea - (windpipe) Infants and children have narrower tracheas that are obstructed more easily by swelling. Trachea is softer and more flexible in infants and children.,Kansas Airway Supplement Kansas BEMS EMS Educator Task Force,1
10、2,Infant and Child Considerations,Cricoid cartilage - like other cartilage in the infant and child, the cricoid cartilage is less developed and less rigid. It is the narrowest part of the infants or childs airway. Diaphragm - chest wall is softer, infants and children tend to depend more heavily on
11、the diaphragm for breathing.,Kansas Airway Supplement Kansas BEMS EMS Educator Task Force,13,Opening the Mouth,Crossed-finger technique Inspect the mouth Vomit Blood Secretions Foreign bodies Be extremely cautious Fingers Gag or vomit,Kansas Airway Supplement Kansas BEMS EMS Educator Task Force,14,O
12、pening the Airway,Head-tilt, chin lift maneuver Adults vs Infants and Children Jaw thrust maneuver,Kansas Airway Supplement Kansas BEMS EMS Educator Task Force,15,Techniques of Suctioning,BSI precautions Purpose Remove blood, other liquids, and food particles from the airway Some suction units are i
13、nadequate for removing solid objects like teeth, foreign bodies, and food A patient needs to be suctioned immediately when a gurgling sound is heard with artificial ventilation,Kansas Airway Supplement Kansas BEMS EMS Educator Task Force,16,Types of Suction Units,Mounted Suction Devices Fixed on-boa
14、rd the ambulance 300mmHg pull on gauge when tubing is clamped Should be adjustable for infants and children,Kansas Airway Supplement Kansas BEMS EMS Educator Task Force,17,Portable Suction Devices,Electric - battery powered Oxygen - powered Hand - powered Each device must have Wide-bore, thick walle
15、d, non-kink tubing Plastic collection bottle, supply of water Enough vacuum to clear the throat,Kansas Airway Supplement Kansas BEMS EMS Educator Task Force,18,Suction Catheters,Hard or rigid catheter (Yankaeur) Tonsil tip Used to suction mouth and oropharynx Inserted a limited depth Use caution on
16、infants and children Soft tissue damage,Kansas Airway Supplement Kansas BEMS EMS Educator Task Force,19,Soft catheter (French catheter) Used to suction mouth or nose and nasopharynx Measured from tip of the nose to the tip of the ear. Not inserted beyond the base of the tongue,Suction Catheters,Kansas Airway Supplement Kansas BEMS EMS Educator Task Force,20,Techniques of Suctioning,Best positioned at patients head Turn on the suction unit Select catheter Measure and insert without suct
