Anesthesia Clinical Rotation 2007Female Group E1I've made this
note depending on my notes I wrote during the rotation .. Hope you
find it helpful & useful .. Wish you all the best & don't
forget me from your prayers .. Best of luck in the exam Iman A.
Al-MukhtarAir wa Mana!ement.. Air wa "#struction$ %i!ns o& Air
wa "#struction in non-intu#ate' patients $ ! "oisy Breathing #he
commonest sign . $ ! %sing the accessory respiratory muscles .
& ! By 'uscultation ( une)ual air entry to both lungs . * ! 'ir
hunger & distress .+ ! ,yanosis in sever or prolonged
obstruction . Common Causes o& Air wa "#struction in
non-intu#ate' patients ! "asal ,avity -bstruction . e.g ( .eviated
"asal /eptum . $ ! -ral ,avity -bstruction . e.g ( #ongue 0all
against the posterior pharyngeal wall . it is the commonest cause .
& ! 1aryngeal /pasm . e.g ( 1aryngitis .. * ! #racheal &
Bronchi -bstruction . e.g ( 0oreign Body 2 Hyperactive air way 3
full of secretions 3 Common Causes o& Air wa "#struction in
intu#ate' patients $ ! High air way pressure #he commonest cause .
$ ! 4echanical -bstruction . e.g ( Blood clot 2 secretary bluge .
& ! 5hysiological -bstruction . e.g ( 'sthma induced
bronchospasm . #here in "- "oisy Breathing in intubated patients .
(ow to make patent Air wa ) Head 1ift in non! traumati6e
patients7aw #hrust in traumati6e patientsAir wa Instruments .. * 1
+ "ropharn!eal Airwa$In'ication$,pper Air wa "#struction mainl #
ton!ue &all . Contrain'ications $ 1 - %emiconscious patient . *
#c- it will stimulate !a! re&le. causin! /omitin! 0 aspiration
+ 2 - 1atient with multiple man'i#le &ractures .2 - 1atient
with multiple ton!ue in3uries .2 - 1atient with har' teeth
clenchin! .* 2 + 4asopharn!eal Airwa$In'ication$,pper Air wa
"#struction 0 the patient 'oesn5t &it &ororopharn!eal air
wa insertion . Contrain'ications $ 1 - 6asal %kull Fracture 7
A#solute Contrain'ication 7 otherwise ou will insert it to the
#rain 0 cause se/er uncontrolla#lecomplications .2 - Epista.is . 2
- 8e/iate' 4asal %eptum or other nasal 'e&ormit . 9 - Fracture
4ose . : - 4asal In&ection . * 2 + C"1A + Cu&&e'
"ropharn!eal Airwa$ + It is an "ropharn!eal Airwa with a
cu&& to pre/ent an air leak .
* 9 + ;arn!eal Mask Airwa + ;MA $ + Insert the mask in front of
the larynx to ventilate the patient . #here are many si6es 8 for
adults & neonates 9 %se the largest si6e that your patient can
accommodate . A'/anta!es$ ! .oesn't need an expert to insert it . $
! :asley administered . 8isa'/anta!e$.oesn't prevent aspiration .
It is not the ideal ventiltory device . It is used for life saving
cases . ,an be used electively in -; patients E.press$ +It is a
modified laryngeal tube with wider opening . 8isa'/anta!e$#his most
traumati6ing airway device 99 * 7 + Com#