creation date: 2025-10-05 11:37
tags: Interventions Incomplete
Airway Management
Background
Airway management ensures a patent airway between the lungs and the environment to maintain oxygenation and ventilation.
Note, that if indications are not met, non-invasive oxygen may be sufficient (eg. via nasal cannula).
General Steps
Airway Position & Clearance
Upper airway obstruction should be relieved by head tile, chin lift, and/or jaw thrust. Suction may be used to remove mucus or other debris, especially in infants/children.
Bag-Mask Ventilation
Bag-Mask is both crucial for pre-oxygenation (in cases of ET intubation) and for ventilation prior to connection to a more permanent oxygen source.
Nasopharyngeal / Oropharyngeal Airway
Indications & Contraindications
Adjuvant airway devices are indicated for patients who have:
- Intact gag reflex
- Trismus
- Oral trauma
- Those who have undergone oral/oropharyngeal surgery in which oral cavity should not be instrumented
Preparation
Procedure
Endotracheal Intubation
Indications & Contraindications
Endotracheal intubation is indicated for:
- Respiratory failure (hypoxic or hypercapnic)
- Apnea
- Reduced level of consciousness (typically GCS < 8)
- Inability to protect airway (no gag reflex)
- Rapid changes in mental status
- Airway injury or impending airway compromise
- High aspiration risk
- Laryngeal trauma (penetrating injury to neck, abdomen, chest)
Contraindications include:
- Severe airway trauma or obstruction preventing safe placement of ETT
Preparation
Procedure
Surgical Airway (Cricothyroidotomy)
Indications & Contraindications
Cricothyroidotomy is indicated for patients in which a endotracheal tube is not possible.
The only absolute contraindication to cricothyroidotomy is age in which the lower limit is suggested to be somewhere between 5-12, albeit unclear. In such cases, a needle cricothyrotomy is performed.