氣道通氣的識(shí)別和評(píng)估（英文）_第1頁(yè)
氣道通氣的識(shí)別和評(píng)估（英文）_第2頁(yè)
氣道通氣的識(shí)別和評(píng)估（英文）_第3頁(yè)
氣道通氣的識(shí)別和評(píng)估（英文）_第4頁(yè)
氣道通氣的識(shí)別和評(píng)估（英文）_第5頁(yè)
已閱讀5頁(yè)，還剩32頁(yè)未讀， 繼續(xù)免費(fèi)閱讀

下載本文檔

版權(quán)說(shuō)明：本文檔由用戶提供并上傳，收益歸屬內(nèi)容提供方，若內(nèi)容存在侵權(quán)，請(qǐng)進(jìn)行舉報(bào)或認(rèn)領(lǐng)

文檔簡(jiǎn)介

Assessment&RecognitionofAirway&VentilatoryCompromiseHistoryOnsetsuddenvsgradualKnowncause?DurationConstantRecurrentProvocation/PalliationAssessment&RecognitionofAirway&VentilatoryCompromiseExacerbationAssociatedSigns/SymptomsCough,chestpain,feverInterventionspastevals/admitsmedseverintubatedbefore?Assessment&RecognitionofAirway&VentilatoryCompromiseRespiratoryPatternsCheyne-StokesbrainstemKussmaulacidosisBiot’sincreasedICPRespiratoryPatternsCentralNeurogenicHyperventilationincreasedICPAgonalbrainanoxiaAssessment&RecognitionofAirway&VentilatoryCompromiseInadequateVentilationbodycannotcompensateforincreasedoxygendemandormaintainbalanceCausesinfectiontraumabrainsteminjurytoxicinhalationrenalfailureAirway&VentilationMethods:BLSSupplementalOxygenincreasedFiO2increasesavailableoxygenobjectiveistomaximizehemoglobinsaturationAirway&VentilationMethods:BLSOxygensourcecompressedgasliquidoxygenRegulatorsHumidifierDeliveryDevicesnasalcannulapartialrebreathermasknon-rebreathermaskventurimasksmallvolumenebulizerAirway&VentilationMethods:BLSAirwayManeuversHead-tilt/Chin-liftJawthrustSellick’smaneuverOtherTypestracheostomywithtubetracheostomywithstomaAirwayDevicesOropharyngealairwayNasopharyngealairwayAirway&VentilationMethods:BLSMouthtoMouthMouthtoNoseMouthtoMaskOnepersonBVMTwopersonBVMThreepersonBVMFlowrestrictedpoweredventilatorTransportventilatorOnePersonBVMdifficulttomastermasksealofteninadequatemayresultininadequatetidalvolgastricdistentionriskventilateonlyuntilseechestriseAirway&VentilationMethods:BLSTwopersonBVMmostefficientmethodUsefulinC-spineinjimprovedmasksealandtidalvolumeThreepersonBVMlessutilizedusedwhendifficultywithmasksealcrowdedAirway&VentilationMethods:BLSFlow-restricted,poweredventilatorCardiacsphincteropensat30cmH2Ohighvolume/highconcnotrecommendedforchildren,noncompliantorpoortidalvolumeoxygendeliveredoninspiratoryeffortmaycausebarotraumaAirway&VentilationMethods:BLSAutomatictransportventilatorsNotlikea“real〞ventilatorUsuallyonlycontrolsVolumeandrateUsefulduringprolongedventilationtimesNotusefulinobstructedairwayorincreasedairwayresistanceFreespersonnelCannotdetectchangesAirway&VentilationMethods:BLSPediatricconsiderationsmasksealforcemayobstructairwaybestifusedwithjawthrustBVMsizes:neonate&infant=450ml+Children>8yoarequireadultBVMjustenoughvolumetoseechestriseSqueeze-Release-ReleaseAirway&VentilationMethods:BLSStomapatientsexposestomapocketmaskBVMSealaroundstomasitesealmouthandnoseifairleakisevidentAirway&VentilationMethods:BLSAirwayObstructionTechniquesPositioningOPA/NPAHeimlichmaneuverFingersweepwithcautionChestThrustsChestthrustandbackblowsforinfantsSuctioningDirectlaryngoscopyAirway&VentilationMethods:BLSSuctioningManualorPowereddevicesSuctioncathetersrigidsoftTracheobronchialsuctioninglubricatecatheter3-5ccsterilewaterorsalineinsertcatheteruntilresistanceisfeltAirway&VentilationMethods:BLSGastricDistentionCommonwhenventilatingwithoutintubationpressureondiaphragmresistancetoBVMventilationincreasetimeofBVMventilationAirwayManagement:

Part2EMSProfessionsTempleCollegeAirway&VentilationMethods:ALSGastricTubesnasogastriccautionwithesophagealdiseaseorfacialtraumatoleratedbyawakepatientsbutisuncomfortablepatientcanspeakinterfereswithBVMsealorogastricusuallyusedinunresponsivepatientslargertubemaybeusedsafeinfacialtraumaAirway&VentilationMethods:ALSNasogastricTubeInsertionSelectsize(french)MeasurelengthnosetoeartoxiphoidLubricateendoftubewatersolubleMaintainaseptictechniquePositionpatientsittingupifpossibleAirway&VentilationMethods:ALSNasogastricTubeInsertion(cont)InsertintonaretowardsbaseAdvancegraduallybutsteadilytomeasuredlengthHavepatientswallowAssessplacement&secureInstillair&ausculateaspirategastriccontentsMayconnecttolowvacuum(80-100mmHg)Airway&VentilationMethods:ALSOrogastricTubeInsertionSelectsize(french)MeasurelengthLubricateendoftubeMaintainaseptictechniquePositionpatient(usuallysupine)InsertintomouthAdvancegraduallybutsteadilyAirway&VentilationMethods:ALSOrogastricTubeInsertion(cont)Assessplacement&secureinstillairoraspirateEvacuatecontentsasneededAirway&VentilationMethods:ALSEndotrachealIntubationTubeintothetracheatoprovideventilationsusingBVMorventilatorSizedbaseduponinsidediameterinmmLengthsincreasewithincreasedIDcmmarkingsalonglengthCuffedvsUncuffedAirway&VentilationMethods:ALSEndotrachealIntubationIndicationspresentorimpendingrespiratoryfailureapneaunabletoprotectownairwayAdvantagessecuresairwayrouteforafewmedicationsoptimizesventilationandoxygenationAirway&VentilationMethods:ALSTheseareNOTIndicationsBecauseIcanintubateBecausetheyareunresponsiveBecauseIcan’tshowupatthehospitalwithoutitAirway&VentilationMethods:ALSComplicationsofendotrachealintubationBleedingordentalinjuryLaryngealedemaLaryngospasmVocalcordinjuryBarotraumaHypoxiaAspirationDislodgedtubeoresophagealintubationRightorLeftmainstemintubationAirway&VentilationMethods:ALSTechniquesofInsertionOrotrachealIntubationbydirectlaryngoscopyBlindNasotrachealIntubationDigitalIntubationRetrogradeIntubationTransilluminationtechniquesAirway&VentilationMethods:ALSOrotrachealIntubationbydirectlaryngoscopyPosition&VentilatepatientMonitorpatientECGPulseoximeterAssesspatient’sairwayfordifficultyAssemble&checkequipment(suction)Hyperventilatepatient(30-120sec)Airway&VentilationMethods:ALSOrotrachealIntubationbydirectlaryngoscopy(cont)PositionpatientOpenmouth&insertlaryngoscopebladeAttempttosweeptongue(straightblade)IdentifyanatomicallandmarksAdvancelaryngoscopebladeValleculaforcurved(Miller)bladeUnderepiglottisforstraight(Miller)bladeAirway&VentilationMethods:ALSOrotrachealIntubationbydirectlaryngoscopy(cont)ElevateepiglottisDirectlywithstraight(miller)bladeIndirectlywithcurved(macintosh)bladeVisualizethevocalcords&glotticopeningEnterthemouthwiththetubefromcornerofmouthAirway&VentilationMethods:ALSOrotrachealIntubationbydirectlaryngoscopy(cont)Advanceintoglotticopeningapprox.1/2inchpastvocalcordsContinuetoholdtube¬elocationInflatecuffuntilfirm(approx10cc)Ventilate&AuscultateepigastriumleftandrightchestAirway&VentilationMethods:ALSOrotrachealIntubationbydirectlaryngoscopy(cont)SecuretubeReassessVentilationEffectivenessauscultationclinicalsignsend-tidalCO2EsophagealdetectiondeviceAirway&VentilationMethods:ALS

溫馨提示

  • 1. 本站所有資源如無(wú)特殊說(shuō)明，都需要本地電腦安裝OFFICE2007和PDF閱讀器。圖紙軟件為CAD,CAXA,PROE,UG,SolidWorks等.壓縮文件請(qǐng)下載最新的WinRAR軟件解壓。
  • 2. 本站的文檔不包含任何第三方提供的附件圖紙等，如果需要附件，請(qǐng)聯(lián)系上傳者。文件的所有權(quán)益歸上傳用戶所有。
  • 3. 本站RAR壓縮包中若帶圖紙，網(wǎng)頁(yè)內(nèi)容里面會(huì)有圖紙預(yù)覽，若沒(méi)有圖紙預(yù)覽就沒(méi)有圖紙。
  • 4. 未經(jīng)權(quán)益所有人同意不得將文件中的內(nèi)容挪作商業(yè)或盈利用途。
  • 5. 人人文庫(kù)網(wǎng)僅提供信息存儲(chǔ)空間，僅對(duì)用戶上傳內(nèi)容的表現(xiàn)方式做保護(hù)處理，對(duì)用戶上傳分享的文檔內(nèi)容本身不做任何修改或編輯，并不能對(duì)任何下載內(nèi)容負(fù)責(zé)。
  • 6. 下載文件中如有侵權(quán)或不適當(dāng)內(nèi)容，請(qǐng)與我們聯(lián)系，我們立即糾正。
  • 7. 本站不保證下載資源的準(zhǔn)確性、安全性和完整性, 同時(shí)也不承擔(dān)用戶因使用這些下載資源對(duì)自己和他人造成任何形式的傷害或損失。

評(píng)論

0/150

提交評(píng)論