AIRWAY OBSTRUCTION

Trauma foreign bodies

inflammation

hematomas

CNS disease secretions

Drug overdose

Infections glottitis

Obstructive sleep apnea

ETIOLOGY IN DAILY LIFE

They lack molars for proper grinding of food.

They tend to be running or playing at the time of aspiration.

They tend to put objects in their mouth more frequently.

They lack coordination of swallowing and glottis closure.

Curiosity, boredom

ASPIRATION - PREVENTION

Most Objects Enter GI Tract

Epiglottis Seals Trachea

Use Rubber Dam

Use Posterior Oral Packing

Suction/Assistant

Magill Forceps

FOREIGN BODY ASPIRATION/INGESTION

Can Be Critical

Good chance of Retrieval If PtConscious

Small Items May Pass Through Trachea

3000/year Die From Airway Obstruction

Most Common Item Is Food

SWALLOWED OBJECTS

Keep Patient Supine??

Magill Forceps

Head Down Position

If Unable to Visualize……….

ASPIRATED OBJECTS

Airway Obstruction - Partial/Complete

Level of Obstruction

Place Patient in Right Lateral Decubitus

Encourage Cough

Be Alert to Airway Obstruction

SITE OF LODGING OF FOREIGN BODY RIGHT

MAIN BRONCHUS

The diameter of the right main bronchus is larger than the left,

The angle of divergence from the tracheal axis is smaller on the right,

Airflow through the right lung is greater than through the left,

The carina is more likely to be located to the left of midline rather than to the right.

FOREIGN BODY ASPIRATION

Complete airway obstruction

Choking sign

Respiratory distress

Inability to speak or cough

Partial airway obstruction

Coughing

Gagging

Throat clearing

Back blows/robipng hypopharynx not

recommended

FOREIGN BODY ASPIRATION

TREATMENT

Back blows

Is not common for adult and children

Heimlich maneuver

Chest thrust

Finger sweep

COMPLETE AIRWAY OBSTRUCTION

MANAGEMENT

< one year

Back blows and chest thrust….. NEVER perform an abdominal thrust on an infant

> one year

Gentle abdominal thrusts while supine

Older children/adults

Heimlich maneuver(abdominal thrust)

IF YOUR PATIENT IS UNCONSCIOUS…

BLS(Base Life Support);

Supine position

Head tilt chin lift

Look & listen & feel

Jaw thrust

Heimlich maneuver

Finger sweep

Chest thrust

TREATMENT OF INFANTS

Infants under 1 year of age:

A combination of 5 back blows (with the flat of the hand) and 5 abdominal thrusts (with 2 fingers on the upper abdomen).

HEIMLICH MANEUVER

FINGER SWEEP

UNIVERSAL DISTRESS SIGNAL FOR FOREIGN

BODY AIRWAY OBSTRUCTION. .

SUBDIAPHRAGMATIC ABDOMINAL THRUST

(THE HEIMLICH MANEUVER) ADMINISTERED TO A

CONSCIOUS (STANDING) VICTIM OF FOREIGN BODY

AIRWAY OBSTRUCTION.

SUBDIAPHRAGMATIC ABDOMINAL THRUST (THE

HEIMLICH MANEUVER) ADMINISTERED TO AN

UNCONSCIOUS (LYING) VICTIM OF FOREIGN BODY

AIRWAY OBSTRUCTION - ASTRIDE POSITION

FINGER SWEEP MANEUVER

ADMINISTERED TO AN UNCONSCIOUS

VICTIM OF FOREIGN BODY AIRWAY

OBSTRUCTION.

CROSSED-FINGER TECHNIQUE FOR

OPENING THE AIRWAY

CHEST THRUST ADMINISTERED TO A

CONSCIOUS VICTIM (STANDING) OF

FOREIGN BODY AIRWAY OBSTRUCTION

CHEST THRUST ADMINISTERED TO AN

UNCONSCIOUS VICTIM (LYING) OF

FOREIGN BODY AIRWAY OBSTRUCTION.

LOCATING HAND POSITION FOR CHEST

COMPRESSIONS IN A CHILD.

HEIMLICH MANEUVER - CONSCIOUS

CHILD STANDING

HEIMLICH MANEUVER - CONSCIOUS OR

UNCONSCIOUS CHILD, LYING

BACK BLOW IN AN INFANT

CHEST THRUST IN AN INFANT

FINALLY…..

Tracheostomy

cricothyrotomy