Airway Management

Amplified
Checklist

Airway Management - Amplified

Anatomy

Upper Airway Structures

  • Nasopharynx: above soft palate
  • Oropharynx: soft palate to epiglottis
  • Laryngopharynx: epiglottis to cricoid

Causes of Obstruction

  • Tongue: most common in unconscious (falls back)
  • Foreign body: food, teeth, vomit
  • Swelling: anaphylaxis, burns, infection
  • Blood/secretions
  • Structural: trauma, tumour

Assessment

Signs of Obstruction

Partial obstruction:

  • Stridor, snoring, gurgling
  • Use of accessory muscles
  • Paradoxical breathing

Complete obstruction:

  • Silence (no air movement)
  • Severe distress → unconsciousness
  • Cyanosis
  • See-saw chest/abdominal movement

Airway Adjuncts

Oropharyngeal Airway (OPA/Guedel)

Sizing: corner of mouth to angle of mandible Insertion: insert upside down, rotate 180° at soft palate Contraindications: gag reflex present (will induce vomiting)

Nasopharyngeal Airway (NPA)

Sizing: tip of nose to tragus of ear Insertion: perpendicular to face, bevel towards septum, lubricate Contraindications: base of skull fracture (relative), anticoagulation

Supraglottic Airways (LMA/i-gel)

Indications: failed BVM, can't intubate Sizing: by patient weight Benefits: easier than intubation, can ventilate during insertion

Definitive Airways

Endotracheal Intubation

Indications:

  • GCS ≤8
  • Unable to protect airway
  • Need for controlled ventilation
  • Severe facial/airway burns

Complications:

  • Oesophageal intubation
  • Right main bronchus intubation
  • Trauma to teeth/larynx
  • Aspiration

Surgical Airway

Indication: can't intubate, can't oxygenate Options: cricothyroidotomy, tracheostomy