Airway Management and Ventilation Procedures: Skill Assessment Guide

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Airway Management and Ventilation Procedures

Introduction

This study guide summarizes the essential steps and standards for performing airway management and ventilation procedures, as assessed in a clinical skills test. The procedures covered are foundational for emergency medical care and are relevant to Anatomy & Physiology students studying respiratory system interventions and airway patency.

Conditions and Equipment

Overview of Airway Management Setup

Airway management manikin and mechanical ventilation devices are used for simulation.
Students must verify all necessary equipment before beginning procedures.

Essential Equipment List

Gloves, goggles
Oropharyngeal and nasopharyngeal airways
Flexible suction catheter, rigid suction catheter
Nasal cannula, non-rebreather mask, pocket mask
Endotracheal tube, stylet, syringe
Bag-valve-mask (BVM) with reservoir
Oxygen tank, wrench, oxygen connecting tubing
Thomas tube holder, battery-powered suction unit
Regulator with flow meter and PEEP capability

Standards and Scoring

Skill Test Requirements

All procedures must be completed within 15 minutes.
Each step is assigned a point value (10, 20, or 30 points).
A total deduction of fewer than 30 points is required to pass.

Procedural Steps and Explanations

1. Assembling the Oxygen Tank and Regulator

Proper assembly ensures safe delivery of oxygen to the patient.

Personal Protective Equipment (PPE): Always wear gloves and goggles.
Regulator Attachment: Secure the regulator to the tank, ensuring it is tight and properly aligned.
Opening the Tank: Open the valve with appropriate tools, check for leaks, and ensure the gauge is facing outward.
Safety Checks: Confirm tank pressure is above 500 psi and secure with straps.

2. Administering Oxygen via Nasal Cannula

Nasal cannulas are used for patients requiring low to moderate oxygen supplementation.

Select the correct cannula and attach to the flow meter nipple.
Set flow rate (1-6 L/min).
Place cannula on patient, ensuring prongs are in the nostrils and tubing is secure.

3. Administering Oxygen via Non-Rebreather Mask

Non-rebreather masks deliver high concentrations of oxygen to patients in respiratory distress.

Select the correct mask and attach to flow meter nipple.
Set flow rate (10-15 L/min).
Fill reservoir bag with oxygen before placing mask on patient.
Ensure mask fits snugly and check for deflation during inhalation.

4. Oropharyngeal Airway (OPA) Insertion

OPA is used for unconscious patients without a gag reflex to maintain airway patency.

Determine appropriate size by measuring from corner of mouth to earlobe.
Insert OPA using the correct technique (rotate 180 degrees or use tongue depressor).
Open patient’s mouth using head-tilt chin-lift or jaw-thrust maneuver.
Assess breathing for 3-5 seconds and observe chest rise.

5. Nasopharyngeal Airway (NPA) Insertion

NPA is used for semi-conscious patients with an intact gag reflex.

Determine correct size by measuring from nostril to earlobe.
Lubricate and insert NPA gently, bevel toward septum.
Assess breathing and observe chest rise.

6. Bag-Valve-Mask (BVM) Ventilation

BVM is used for patients who are not breathing or require assisted ventilation.

Position mask and ensure proper seal.
Attach oxygen and set flow rate to 15 L/min.
Ventilate in a smooth, rhythmic fashion (1 breath every 5-6 seconds for adults).
Observe chest rise and count aloud to ensure proper timing.

7. Suctioning the Pharynx

Suctioning removes secretions to maintain airway patency.

Use rigid or flexible catheter as appropriate.
Turn on suction device and check for proper function.
Insert catheter only as far as necessary (no more than the distance from mouth to earlobe).
Suction in a circular motion while withdrawing catheter.
Limit suction time: 15 seconds for adults, 10 seconds for children, 5 seconds for infants.

8. Endotracheal Tube Preparation and Ventilation

Endotracheal intubation is performed for advanced airway management.

Gather all necessary equipment (tube, stylet, syringe, suction).
Test cuff inflation and prepare tube for insertion.
Attach BVM and ventilate, ensuring proper placement and chest rise.
Monitor and notify if tube position changes.

Key Terms and Definitions

Oropharyngeal Airway (OPA): A device inserted into the mouth to keep the airway open in unconscious patients.
Nasopharyngeal Airway (NPA): A tube inserted into the nose to maintain airway patency in semi-conscious patients.
Bag-Valve-Mask (BVM): A handheld device used to provide positive pressure ventilation to patients who are not breathing adequately.
Endotracheal Tube: A tube placed into the trachea to secure the airway and allow for mechanical ventilation.
Suction Catheter: A device used to remove secretions from the airway.

Summary Table: Airway Management Devices and Indications

Device	Indication	Key Steps
Nasal Cannula	Spontaneously breathing patient needing low-flow O2	Select cannula, attach to flow meter, set 1-6 L/min, place on patient
Non-Rebreather Mask	Patient in respiratory distress needing high-flow O2	Attach mask, set 10-15 L/min, fill reservoir, place on patient
OPA	Unconscious, no gag reflex	Size airway, insert, assess breathing
NPA	Semi-conscious, intact gag reflex	Size airway, lubricate, insert, assess breathing
BVM	Non-breathing or inadequate breathing	Position mask, attach O2, ventilate, observe chest rise
Endotracheal Tube	Advanced airway management	Prepare tube, insert, attach BVM, ventilate
Suction Catheter	Remove airway secretions	Turn on device, insert catheter, suction while withdrawing

Formulas and Equations

Oxygen Flow Rate:
Suction Duration:

Additional info:

These procedures are foundational for emergency airway management and are directly relevant to the anatomy and physiology of the respiratory system.
Understanding the indications and contraindications for each device is essential for safe patient care.