BLS Airway Management (Opening the Airway)

hi guys my name is Sam and welcome to pragmatic in today's video we'll be discussing how to open a patient's airway so your airway is everything between the mouth and the lungs and what we're going to be discussing here is how to open that how to make sure that there is direct communication between the lungs and the air that somebody needs to live so we're not going to be discussing how to provide rescue breath for a patient that will be in a later video that I'll do but this is a precursor to that if we go to the initial assessment it goes airway then breathing so the securing of somebody's airway or the opening of somebody's airway is going to be your first step so what are the signs of a airway potential airway obstruction and what's going to cause it so an airway obstruction can occur in anybody with an altered level of consciousness and potentially somebody that's completely conscious if they're choking this is not a Heimlich video there's a lot of stuff out there on that I'd advise you learn the Heimlich we're going to be talking more about the altered level responsiveness so the most common cause of an airway obstruction is going to be somebody's tongue if they're unresponsive they're not able to protect it that tongue is falling back so the first maneuver that you can do as a provider to open somebody's airway if you come to them and they've got snoring respirations if they're not breathing regularly or if they're not breathing we need to open that manually so your first option is going to be a head tilt chin lift and that's simply putting your hand on their forehead and their chin and lifting the patient's head up that's going to lift the tongue off the oral pharynx and give you a better align down to the lungs so that you can provide those breaths for them or if they're still breathing on their own they can effectively breathe the second option if you suspect they have a spinal injury obviously it's not that great to be cranking their head back like that so your second option is going to be a jaw thrust maneuver and that's grabbing right behind their mandible and pulling forward and that's going to jut their jaw out and once again pull the tongue off the oral pharynx this is a lot harder to do especially if you're on your own so if you try that once and it fails go ahead and go to the head-tilt chin-lift because the potential for a spinal injury is never going to outweigh in very real airway obstruction if you're providing rescue breaths for the patient both of these techniques should be used in conjunction with that mask is pretty easy to do you just have to alter your grip on the mask slightly there are some tools out there that are going to help you open a patient's airway those are your NPA's and your opiates your nasal pharyngeal Airways and your oral pharyngeal Airways your oral pharyngeal Airways are a plastic hook like device that's going to be measured so it's going to be measured from the corner of the mouth to the angle of the jaw and those are going to be inserted one of two ways the by-the-book method is going to be a cross finger technique so putting your thumb and your pointer finger in the patient's mouth and opening like that then inserting your OPA at a 180 degree angle and rotating down into the pharynx and that's going to cup the tongue bring that forward and make sure that you have an open airway draw back of your OPA ziz that they will trigger a gag reflex so these are generally only used on somebody that's in cardiac arrest or very very close to cardiac arrest and you don't want to be putting these in a conscious patient because they're going to vomit now you're gonna have another airway issue down the road so your other option and what I would personally recommend you carrying as a layperson is going to be a NPA an NPA is a nasopharyngeal airway measured very similar to an OPA except it's from the corner of the nose to the earlobe now it's worth mentioning that most of these come in a set so a variety of sizes from very small to very large and it's up to you to find the correct size so the first step in inserting that is measuring it putting on some lubricant which it should come with and then making sure that it's going to follow the M Tama position so they're curved and facing the bevel towards the septum of the nose that's going to keep the tip of that from getting stuck to the side of the pharynx once you've inserted it once you've done all of that you take it and just insert it in line with the patient if you can't get it in one nostril you can take it to the other nostril it's okay if the bubbles facing away it's just not ideal both of these are going to provide a open oral airway for you and they're good to be used in conjunction with your bag mask device or your rescue mask if you are providing rescue breaths to that patient it's important to note that neither of these devices is going to secure an airway so that means that gastric content could still potentially come up and then cause you issues down the line this is simply to open the airway if you want to secure an airway you can use some commercial devices like the King Ltd which is a super glottic airway that can be inserted and inflated in the esophagus to provide that protection that can be used for BLS providers although I would not use this unless you are trained in it and actually authorized to do so by your medical director that's all I have for you today feel free to like this video and subscribe if you're so inclined if you have any questions please leave me a comment down below and I will see you next time [Music]

Channel: PrepMedic

Views: 82,939

Rating: 4.9714627 out of 5

Keywords: Airway managment, Basic life support, OPA, Paramedic, Medical

Id: Ws8XTJDP43M

Length: 6min 24sec (384 seconds)

Published: Fri May 11 2018

Reddit Comments

[u/GreasyAssMechanic]

Inb4 SAFETY PIN THEIR TONGUE TO THEIR JACKET

[u/aConfusedPhilosopher]

So there has been a good bit of info about bleeding control on this sub, but not a lot of airway management. That's reasonable as in the penetrating trauma patient bleeding control is the priority, but airway management deserves a mention as well. This is particularly true for critical/crashing trauma patients, as they likely won't be able to protect and maintain their own airway structures. This video is a very brief but good introduction to some basic concepts and techniques/tools. Feel free to hit me up if you have any questions or comments!

[u/jbrandona119]

If you have an HSA card from your job you can buy these medical supplies, med kits etc...just in case you know you won't be going to the doctor soon but are tight on cash!