Surgical airway inservice 6 2009

Surgical Airways

and the use of the

QuickTrach Devise

Respiratory System

•Temperature Control

•Gas Exchange

•Mechanism

•Diaphragm

•Negative Pressure

Spontaneous Respiration

Pre Hospital Airway Adjuncts•Oropharyngeal & Nasopharyngeal Airways

• Combitube

• King Airway

• Endotracheal Intubation

• Nasotracheal Intubation

• Surgical Airways ( QuickTrach )

Pre Hospital Ventilation Adjuncts* Bag – Valve – Mask

Positive Pressure

Most commonly used in the field.

* Transport Ventilator

Positive Pressure

Automatic Ventilations

No user feedback

* CPAP Unit

Positive Pressure

Continuous Airway Pressure

Surgical Airway Intervention•History

Military and Civilian

Tennessee EMS

•Traditional Procedure

• Benefits to QuickTrach device.

Less complicated than the traditional.

Less invasive than other methods.

No incision is required.

Can be done in moving ambulance.

Minimal training is required.

Indications for the use of Surgical Airway

*All other methods have been exhausted, or are impractical.

*Massive mid-facial trauma precluding the use of BVM

*Inability to control the airway using less invasive measures.

Complications - Surgical Airways*Hypercarbia from prolonged use.

*Damage to surrounding structures.

*Prolonged procedure time.

*Hemorrhage.

*Aspiration.

*Misplacement or false passage of the ETT.

*Perforation of the Esophagus.

Contraindications – Surgical Airways

*Insufficient Training

*Lack of proper equipment.

*Ability to secure the airway by other means.

*Any patient who can be safely intubated, orally or nasally.

*Patients with laryngotracheal injuries.

*Children under 10 years of age.

*Acute laryngeal disease of traumatic or infectious origin.

Description of the QuickTrach Device

*Equipment included in the QuickTrach kit.

*Components

Procedure for Insertion*Gather equipment.

*Patient Positioning

*Puncture of the Cricoid Cartilage.

*Verification of needle entering the airway.

Procedure for Insertion

*Position change for further insertion.

*Remove the stopper.

*Advance catheter and needle.

Procedure for Insertion

*Removal of needle.

*Secure the device.

*Connect extension tubing.

*Ventilate with BVM.

Reassess the patient for any changes ……REASSESS!!

Reassess the patient for any changes ……REASSESS!!

Reassess the patient for any changes ……REASSESS!!

Reassess the patient for any changes ……REASSESS!!

Reassess the patient for any changes ……REASSESS!!

Reassess the patient for any changes ……REASSESS!!

Reassess the patient for any changes ……REASSESS!!

Reassess the patient for any changes ……REASSESS!!

Reassess the patient for any changes ……REASSESS!!

Reassess the patient for any changes ……REASSESS!!