131_airway & Ventilation

7/29/2019 131_airway & Ventilation

1/13

AIRWAY MANAGEMENT

ANDVENTILATION

Prof.Dr. Koeshartono, SpAn K.IC. PGD.Pall.Med (ECU)

Bag / SMF Anestesiologi & Reanimasi

( Kedokteran Gawat Darurat )

FK. Unair - RSU Dr. Soetomo

Surabaya


2/13

At the completion of the course

I. The student will be able to :1. Identify persons who require airway control

2. Define adequate minute volume

Oxygenation

Explain their importanceAs they related to trauma patients

3. Define reduced perfusion

4. Explain the need for increased oxygenation and tidal

volume exchange in trauma patients5. List methods of manual & mechanical airwaymanagement and their correct application techniques

while maintaining in line cervical spine immobilization


3/13

At the completion of the course

II. The student will be able to :

6. List methods of ventilation and their correct application

techniques while maintaining in line cervical spine

immobilization7. List common errors encountered with bagvalve mask

ventilation

8. List the indication, methods and common errors of

percutaneous, transtracheal ventilation endotrachealintubation and need thoracotomy

9. Define the technique for reassessing the result of the

airway and ventilation effort on the trauma patient


4/13

III. Upper Airway

The airway system an open path that leads

atmospheric air through the nose, mouth and

bronchi to the alveoli

Each breath takes 1,2 liters of air

Dead space 250 cc it is not available to the body

to be used for oxygenation


5/13

IV. Patients Airway

The respiratory system is composed of an upper &lower airway some of air that passes into the nose iscontained within the

Pharynx

LarynxTrachea

Bronchi

And thus does not reach the alveoli

This is known as dead space


6/13

V. Upper Portion of the Airway

The upper airwayNasal cavity pharynx

Oral caavity naso, oro, hypo

Nasal cavity Warming

Humidifying

Filtering

Below the pharynx

Esophagus trachea

The next

Stomach

Lower airway


7/13

VI. The first portion of the trachea

Larynx which contains

The vocal cord & muscles

Vestibular fold

Arytenoid cartilage

Epiglottis acting a gate air into the trachea

solids & liquids into the esophagus


8/13

VII. Lower Portion of the Airway

Lower airway

Right & left main stem bronchus

Primary, secondary, tertiary bronchi

Broncholes = very small bronchial tubes

Alveoli :

Tiny air sacsSurrounded by capillaries

Resp. syst meets circ syst. gas exchange occurs


9/13

VIII. Physiology

Oxygen moves into the red blood cells from the alveoli

They are transferred to the cell on the hemoglobin

molecule

After leaving the hemoglobin molecule the oxygentravels into the tissue cell

Carbondioxide travels in the reverse direction but not

on the hemoglobin molecule It travels both in the plasma and in the red blood cell it

self as carbondioxide


10/13

IX. Gas Exchange

Gas exchanging process oxygen is exchanged withcarbondioxide is knownpulmonary diffusion

Oxygenated red blood cell deliver their oxygen whichthe cell then use it, carbondioxide is the released into

the blood plasma this process is called cellulerperfusion

Ventilation is essential for the elimination ofcarbondioxide

The size of each breath = tidal volumeThe minute volume

If the minute volume should

Fall below normal = hypoventilation


11/13

X. Trauma Impact

Trauma can effect the resp. systs ability in six ways

1. Decreased neurologic function

2. Obstruction of the airway

3. Decreased expansion of the lung

4. Decreased absorption of oxygen across the A-C

membrane

5. Decreased blood flow to the alveoli6. Inability of the air to reach the alveoli


12/13

XI. Airway and Ventilation Management

Mechanical airway obstructions

Airway Control

ManualMechanical

Transtracheal

Suctioning Oxygenation & ventilation


13/13

XII. Ventilatory Devices

Masks

BagValveMask (BVM)

Manualy triggered (oxygen powered) devices

131_airway & Ventilation

Documents

Transcript of 131_airway & Ventilation