《呼吸道通气方法 ALS3.ppt》由会员分享，可在线阅读，更多相关《呼吸道通气方法 ALS3.ppt（12页珍藏版）》请在三一文库上搜索。
1、Airway & Ventilation Methods: ALS,Curved (Macintosh) Blade Visualize anatomy Insert from right to left Lift upward and away Blade in vallecula Lift epiglottis indirectly,From AHA ACLS,Airway & Ventilation Methods: ALS,Straight (Miller) Blade Visualize anatomy Insert from right to left moving tongue
2、away Lift upward and away Blade past vallecula and over epiglottis Lift epiglottis directly,From AHA ACLS,Tube Positioning,From TRIPP, CPEM,Airway & Ventilation Methods: ALS,Blind Nasotracheal Intubation Position Do not warm Attach BAAM (if available),Airway & Ventilation Methods: ALS,Blind Nasotrac
3、heal Intubation (cont) Position patient (preferably sitting upright) Insert tube into largest nare Advance slowly but steadily Listen for sound of whistle via BAAM Advance tube Inflate cuff & Assess placement Secure & Reassess,Airway & Ventilation Methods: ALS,Digital Intubation Blind technique Vari
4、able probability of success Using middle fingers to locate epiglottis Lift epiglottis Slide lubricated tube along side fingers Assess tube placement & depth as with orotracheal intubation,Airway & Ventilation Methods: ALS,Digital Intubation,From AMLS, NAEMT,Airway & Ventilation Methods: ALS,Surgical
5、 Cricothyrotomy Indications absolute need for a definitive airway AND unable to perform ETT due for structural or anatomic reasons, AND risk of not intubating is than surgical airway risk OR absolute need for a definitive airway AND unable to clear an upper airway obstruction, AND multiple unsuccess
6、ful attempts at ETT, AND other methods of ventilation do not allow for effective ventilation and respiration,Airway & Ventilation Methods: ALS,Surgical Cricothyrotomy Contraindications (relative) No real demonstrated indication Risks benefits Age 8 years (some say 10) evidence of fx larynx or cricoi
7、d cartilage evidence of tracheal transection,Airway & Ventilation Methods: ALS,Surgical Cricothyrotomy Tips Know your anatomy Short incision, avoid inferior trachea Incise, Do not saw Work quickly. Have a plan Be prepared with a backup plan,Airway & Ventilation Methods: ALS,Needle Cricothyrotomy & Transtracheal Jet Ventilation Indications Same as surgical cricothyrotomy along with Contraindication for surgical cricothyrotomy Contraindications None when demonstrated need caution with tracheal transection,