Emergency DepartmentOf

Rasool-Akram Hospital

Airway ManagementAirway Management

P. Hafezi MDP. Hafezi MDEmergency MedicineEmergency Medicine

Upper-Airway Anatomy:Upper-Airway Anatomy:

NoseNose MouthMouth Nasopharynx Nasopharynx OropharynxOropharynx LarynxLarynx TracheaTrachea

Airway Maneuvers:Airway Maneuvers: (Primary (Primary Airway Management)Airway Management)

Head Tilt-Chin Head Tilt-Chin LiftLift

Jaw Thrust Jaw Thrust

Head tilt-Chin Lift:Head tilt-Chin Lift:

Jaw Thrust:Jaw Thrust:

Airway Devices:Airway Devices: (Secondary Airway (Secondary Airway Management)Management)

Oropharyngeal AirwayOropharyngeal Airway Nasopharyngeal AirwayNasopharyngeal Airway Bag-Mask VentilationBag-Mask Ventilation Laryngeal Mask airway(LMA)Laryngeal Mask airway(LMA) Esophageal-Tracheal CombitubeEsophageal-Tracheal Combitube Orotracheal IntubationOrotracheal Intubation

Oropharyngeal Airway:Oropharyngeal Airway:

Choose The Best OneChoose The Best One

Do Not Use It In CONSCIOUS Patients.

Technique: Technique:

A.InsertionA.Insertion

B.RotationB.Rotation (180 )(180 )

Nasopharyngeal airway:Nasopharyngeal airway:

Choose The Best OneChoose The Best One

Do Not Use It In Skull Bass Fx. Patients.

Bag-Mask V.Bag-Mask V.

Laryngeal Mask Airway Laryngeal Mask Airway (LMA):(LMA):Choose The Best OneChoose The Best One

LMA In Your Hand:LMA In Your Hand:

LMA Insertion Technique:LMA Insertion Technique:

Esophageal Tracheal Esophageal Tracheal Combitube:Combitube:

Esophageal Tracheal Esophageal Tracheal Combitube:Combitube:

Orotracheal Intubation:Orotracheal Intubation:

Indications:Indications:

1.Hypoxemia1.Hypoxemia

2.Hypoventilation2.Hypoventilation

3.Muscle Fatigue3.Muscle Fatigue

4.Airway Protection4.Airway Protection

5.Threatened Airway5.Threatened Airway

6.Out Of ED Facilities 6.Out Of ED Facilities

Prepare Laryngoscope:Prepare Laryngoscope:

Laryngoscope Should Be In Your LEFT Hand

Macintosh (A) and Miller (B) Macintosh (A) and Miller (B) laryngoscope bladeslaryngoscope blades

Mallampati classificationMallampati classification

Prepare Patient:Prepare Patient:

Extend-the-head-on-neck (“look up”): aligns axis A relative to B

Flex-the-neck-on-shoulders (“look down”): aligns axis B relative to C

A

B C

A-B-C

How To Intubate?How To Intubate?

1. Insert The Laryngoscope In 1. Insert The Laryngoscope In RIGHT RIGHT Side Side Of Mouth.Of Mouth.

2. When You See The Epiglottis Push It 2. When You See The Epiglottis Push It UP UP & FORWARD.& FORWARD.

3.3. Now , Now ,You Can See The Vocal Cords.You Can See The Vocal Cords.

Easy To SayDifficult To

Do

True Intubation:True Intubation:

Cormack classificationCormack classification

Vocal Cords To Mouth:Vocal Cords To Mouth:

Intubation By Glidoscope:Intubation By Glidoscope:

Difficult Difficult IntubationIntubation

Intubation Intubation TrainingTraining

Thanks