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Advanced emergency airway management in adults

Advanced emergency airway management in adults

Advanced emergency airway management in adults in Broadway

In the emergency department (ED), emergency airway care is a vital resuscitation procedure, especially in situations of adult trauma. Securing the airway is part of advanced airway care, which guarantees enough breathing and oxygenation. Many techniques, such as endotracheal intubation, supraglottic airway devices like the laryngeal mask airway, and surgical airways like cricothyroidotomy, can be used to accomplish this. To maximise patient results, prompt assessment and appropriate treatment selection are essential. Even though it takes a lot of skill, endotracheal intubation offers reliable airway control. Supraglottic devices, on the other hand, are less difficult to implant and need less expertise, although they might not work as well in some circumstances. When all other options are exhausted, surgical airways are seen as a final choice. These emergency measures must be implemented successfully, and they require the right training and expertise.

Consult our emergency hospital if you need advanced emergency airway management for adult treatment in Broadway.

Discover advanced emergency airway management for adults treatment in Manipal Hospital Broadway. Our expert treatments ensure swift and effective care when it's needed most

FAQ's

ABC stands for airway, breathing, and circulation, and it is the fundamental first aid principle you should understand if someone is unconscious or unresponsive.

  • Airway: Opening someone's airway should be your first step if they are not breathing.

  • Breathing: If someone's airway has been cleaned but they are not still breathing, administer rescue breathing.

  • Circulation: Perform chest compressions to maintain the blood flow while you are performing rescue breathing. Look for a pulse if the person is not responding. Give them chest compressions if their heart has stopped. 

The evaluation, preparation, and sequence of medical treatments needed to preserve or restore a person's breathing is known as airway management. Air can pass through the mouth and nose and into the lungs by keeping the airway open.

The ability to regulate airways is a crucial competency for medical professionals in life-threatening circumstances and is important to emergency care practice. People may experience low blood oxygen levels and perhaps lose their lives if they do not receive the necessary airway treatment in certain circumstances.  
 

The primary method of managing the airway is through proper bag-mask ventilation. Both one- and two-hand techniques can be used for adults and children. For newborns, the one-hand approach is sufficient as it allows for all necessary movements with just one hand. Techniques such as head tilt, chin lift, jaw thrust, and continuous positive airway pressure can all help alleviate blockages in the upper airway during basic mask ventilation. It is recommended to utilise bag-mask ventilation before intubation. 
 

Intubation to secure the airway is indicated in the following cases: 

  • Respiratory failure (hypoxic or hypercapnic)

  • Apnea

  • State of unconsciousness (sometimes defined as a GCS of less than or equal to 8)

  • Abrupt mental status change

  • Airway injury or impending airway compromise

  • High aspiration risk

  • Trauma to the voice box (larynx), which encompasses all penetrating injuries to the neck, abdomen, or chest.

The different types of advanced techniques employed are: 

  • Laryngeal Mask Airways (LMA)

  • ETA with Intubation

  • Cricothyroidectomy

  • Nasopharyngeal Airway (NPA) and Oropharyngeal Airway (OPA)

  • Tracheotomy

  • Endotracheal Airway (ETA) with intubation

  • RSI Rapid Sequence Induction

In emergency medicine, the quickest and most efficient way to manage airway obstruction is by Rapid Sequence Induction (RSI), which combines ETI with drug administration. When someone has a gag reflex, a full stomach, or a life-threatening condition that requires emergency airway treatment, RSI is especially helpful. For those who have experienced known or suspected adverse responses to any of the medications used in RSI, this method might not be appropriate
 

For patients with a complete airway blockage requiring surgery or those with expected difficult airways, Rapid Sequence Intubation (RSI) is not recommended. Certain airway disorders, a narrow oropharynx, or a history of airway management problems are risk factors that require attention. In these situations, alternative techniques must be taken into consideration to provide safe airway management.

All of the supraglottic airway devices consist of laryngeal masks that are made by different manufacturers. The most famous among them is the laryngeal mask airway (LMA). All models of SGAs are equally effective in ensuring airway stability, with a success rate of over 98% for ventilation in patients. 

Healthcare professionals use a variety of methods and specialised tools to successfully manage challenging airways, including:

  • Alternative Devices: When traditional direct laryngoscopy is challenging, alternative devices such as video laryngoscopes and supraglottic airway devices (such as laryngeal mask airways) can be employed.

  • Fibre-optic Bronchoscopy: This method helps with difficult intubation instances by offering a clear, indirect picture of the voice cords and trachea.

  • Surgical Airway Access: Emergency surgical airways such as cricothyroidotomy or tracheostomy may be required to secure the airway in severe cases when other techniques are ineffective.

Complications after intubation may include: 

  • Laryngeal damage

  • Displacement of the tube

  • Unexpected extubation

  • Endotracheal catheter leaks

  • Infections

  • Ventilator-associated pneumonia 

  • Speech and swallowing difficulties

  • Tracheomalacia

  • Tracheoarterial fistula 

  • Tracheoesophageal fistula 

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