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Respiratory & Airway Part Eight

Foreign Bodies in the Airway

Adults commonly choke on food and dentures
Children choke on toys, coins and food

Stridor – high pitched noise heard on inspiration
Cyanosis – bluish color to skin with with hypoxia

Assessment: is it partial or complete obstruction?

  • Retractions – sucking in of soft tissues of the chest during inspiration
  • Tracheal tugging – adam’s apple appears to be pulled upward on inspiration, means there is an airway obstruction
  • Treatment – complete obstruction – FBAO maneuvers
  • Laryngoscopy, use McGill forceps to remove

Suction:

  • Use soft tip to avoid damage, suction on the way out only
  • Can use saline to clean tube between suction attempts
  • Hazards – cardiac dysrhythmia from hypoxia, can stimulate vagal nerve, can stimulate coughing.

Gastric Distention – Air trapped in stomach > decreased lung expansion, resistance to BVM, regurgitation, aspiration, gastric rupture

Put patient in left lateral position and exert moderate pressure on the epigastrum

Gastric Tube – placing a specialized suction tube into the stomach
Complications:

  • Nasal, esophageal or gastric trauma
  • Accidental ET placement
  • Supragastric placement
  • Tube obstruction

Facial Injuries

Assessment: gurgling, stridor, facial trauma

Treament: Manage airway, in line stabilization, suction, roll whole body

Laryngeal Edema/Spasm

Glottis is the narrowest part of the adult’s upper airway. Swelling/spasm narrows resulting in asphyxia.

Laryngeal edema – can result from anaphylaxis, epiglottitis and inhaling smoke

Treatment for swelling – if allergic reaction or anaphylaxis, epinephrine is key

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