AIRWAY 101

UCSF-Fresno

June 19, 2015

Objectives

Understand the LEMON Law and why it is an important predictor of airways

Practice bagging and intubation Practice utilizing airway adjuncts Recognize a difficult airway

Approach to the Airway

Is this airway going to be difficult? What tools do I need? What is my blade of choice? What is my backup plan?

Ideal conditions for intubation

Ideal Lighting, positioning, etc. Plenty of assistance Time to prepare, plan, discuss Option to Abort Empty Stomach Back up available

Adult – Normal Cords

LEMON Law – predictor of difficult intubations L - Look Externally: buck teeth, small jaw,

external trauma E - Evaluate Internally: 3-3-2 M - Mallampati Score: open mouth and

stick out the tongue w/o saying “Aaahh” O - Obstruction: large tongue, neck

tumors, previous trach N - Neck Mobility: chin to chest, neck

range of motion

Look Externally – Is this going to be a difficult or easy airway?

Look Externally – Is this going to be a difficult or easy airway?

Look Externally – Are these going to be a difficult or easy airways?

Evaluate 3-3-2

Mallampati Score

Mallampati Class I & II

Mallampati Class III & IV

Uh Oh!

Look for OBSTRUCTION – Is this going to be a difficult or easy airway?

Neck Mobility – Is this going to be a difficult or easy airway?

Neck Mobility– Is this going to be a difficult or easy airway?

Can’t Intubate, Can’t Ventilate Occurs 1:10,000 patients BVM Failure? You haven’t failed

with the BVM until 2

nasal airways & an

oropharyngeal

airway are in place

NEXT……..

Break up into 2 groups of 5 people

15 minutes at each station

Station 2: Bagging & Airway AdjunctsObjectives:

1. List equipment needed for BLS airway management

2. Master one and two person bagging techniques

3. Practice using airway adjuncts 4. Review intubation roll

Station 3: IntubationObjectives:

1. List the equipment needed for intubation

2. Describe the difference between a Mac and Miller Blade

3. Practice mechanics of intubation

4. List tools to recognize proper ETT placement