Maintenance of patent airway Prepared by : Christian Raveina

MTIN, Changa.

Definition •An artificial airway is device which helps to keep a patent respiratory passage to a patient who is unable to maintain a normal patent airway

Indications for use of artificial airway devices •Patients having obstruction to air passage •Patient with foreign matter obstructing air

passage•Patient with severe pathological condition of

lower airway passage

Types of artificial airway devices

• Oral airway • Nasal airway • Endotracheal tube• Tracheostomy tube

Oral airway

Oral airway •An oral airway is a hollow , curved , rubber or

plastic oropharyngeal tube that fits into the oral cavity •Once inserted , an oral airway prevents the

tongue from falling back & obstructing the airway of unconscious or semi-conscious person• To insert an oral airway , ( by a trained expert )

hyperextended the neck & careful open the mouth

•Pass the airway through the teeth with its tip directed towards the roof of the mouth •Rotate the airway while advancing it towards

the back of the oral cavity • It will slide into place & hold the tongue forward • The end of the tube should lie at the base of the

tongue

• There are various sizes of oral airways appropriate airway selection is essential • The length of an airway should match the

distance between the insertion of the person’s mandible & the chin • Too long an oral airway causes gagging or

coughing • Too short an airway may push the tongue back

into the throat & increase airway obstruction

Nasal airway

Nasal airway • This hollow , soft rubber tube fits into the nasal

passage . It looks like a short endotracheal tube •Once inserted correctly , the inner end of a nasal

airway lies at the base of the tongue & bypasses the airflow obstruction • Select a tube slightly smaller in diameter than

the person’s nostrils

Endotracheal tube

Endotracheal tube • This long , slender , hollow tube is inserted into

the trachea via the mouth or nose • It passes through the vocal cords & its distal tip

sits just above the carina • It is available in variety of sizes

Procedure for insertion of endotracheal tube •Move the bed away from all & remove the back

rest •Adopt a position at the top of bed facing the

patient with your feet in the walk . The airway can be inserted from front • Select the airway of appropriate size•Deflate the cuff completely

• Lubricate the outer cuff•Make the patient in supine position with his/her

neck aligned • Extend the patient’s head & slightly flex his / her

neck •Cling your index finger as a splint . Advance the

airway into patient’s mouth , while applying its upper surface to the surface of palate

•While ensuring that the tube remains in the midline , put the airway backwards & downwards until it reaches the back of pharynx & resistance is felt •Connect the appropriate syringe & inflate

through the cuff with specified amount of air •Connect the ventilatory device to airway

•Confirm the placement of airway by auscultating the chest during inflation & observe bilateral chest movement • Insert an oropharyngeal airway & secure airway

with bandage•Once airway is inserted , deliver continuous

chest compressions without interruptions for ventilations

Tracheostomy tube

Tracheostomy tube • A tracheostomy tube is a hollow tube, with or without

a cuff, that is electively inserted directly into the trachea through a surgical incision• A tracheostomy tube is a curved tube that is inserted

into a tracheostomy stoma (the hole made in the neck and windpipe (Trachea).• A number of tracheostomy tubes are available for

neonatal, pediatric, and adult uses appropriate size should be selected for the use

Thank you…