Advanced Cardiac Life Support Key Feature 5: Ensure adequate ventilation (i.e., with a bag valve mask), and secure the airway in a timely manner. Skill: Clinical Reasoning, Selectivity Phase: Treatment Pneumonia Key Feature 6: In the patient with pneumonia and early signs of respiratory distress, assess, and reassess periodically, the need for respiratory support (bilevel positive airway pressure, continuous positive airway pressure, intubation) (i.e., look for the need before decompensation occurs). Skill: Clinical Reasoning, Selectivity Phase: Treatment Trauma Key Feature 4: In trauma patients, secure the airway appropriately (ex: assume cervical spine injury, use conscious sedation, recognize a difficult airway, plan for back-up methods/cricothyrotomy). Skill: Clinical Reasoning, Selectivity Phase: Treatment, Hypothesis generation Okay, this is going to be a ridiculously long post that goes over three procedures with regards to resuscitation of airway and breathing. My approach to these procedures comes directly from Procedures Consult: Basic Airway Management, Orotracheal Intubation, Laryngeal Mask Airway Insertion. Consider this whole blog post a direct quotation from these articles, minus the pictures, which are Google originals. These procedures are life-saving maneuvers to employ in the patient with airway or respiratory compromise, or in those who are at impending risk of failure. There is a delicate balance between performing these intrusive procedures and potentially improving morbidity and mortality outcomes and intervening unnecessarily and causing undue harm. In patients who are in that limbo position, it is important to continue to monitor extremely closely and be prepared for signs of decompensation when they occur to allow for as much time as possible to avoid any of the many complications that may occur when employing these techniques. Oral Airway Insertion ![]() Indications Who needs an oral airway? Anyone with airway obstruction. Reasons for this include:
Contraindications In whom is it contraindicated to insert an oral airway?
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Bag-and-Mask Ventilation (BMV) Indications Who requires BMV? Anyone with inadequate respiratory effort. Causes may be intrinsic (ex: due to patient disease) or extrinsic (ex: toxins such a opioids). Inadequate respiratory effort may be difficult to ascertain. Detection depends on close observation of chest wall movement and requires that the patient be undressed so the respiratory rate, pattern and depth of breathing, use of accessory muscles, and signs of injury can be seen. Contraindications In whom is it contraindicated to provide BMV?
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Procedure
Things to Consider
Endotracheal Intubation Indications There are four principal scenarios in which intubation is required and should be done immediately if initial corrective measures fail.
Contraindications
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Things to Consider
Indications
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