Airway Assessment and Management


Algorithm: Assessment and Management of Airway

Must-Know Essentials: Assessment of Compromised Airway

Manifestations of Compromised Airway

  • Patient unable to verbalize

  • Noisy breathing

  • Stridor

  • Patient using or retracting accessary muscles of breathing

  • Agitation

  • Central nervous depression

  • Tachypnea

  • Cyanosis

  • Low oxygen saturation

Must-Know Essentials: Definitive Airway

Definition of Definitive Airway

  • A tube in the trachea with a cuff inflated below the vocal cords

Indications for Definitive Airway

  • Maxillofacial trauma:

    • Midface fractures

    • Bilateral mandibular body fracture

  • Inhalation injury

  • Penetrating neck injury

    • Vascular trauma with significant neck hematoma

  • Laryngeal injury: triad of clinical signs

    • Hoarseness

    • Subcutaneous emphysema

    • Palpable fracture

  • Tracheal injury

  • Risk of aspiration

    • Bleeding in the oral cavity

    • Vomiting

    • Unresponsive patients

  • Need for ventilation or oxygenation

  • Inadequate respiratory efforts

    • High cervical spinal cord injury

    • Severe brain injury (Glasgow Coma Scale [GCS] 8 or less)

  • Apnea

    • Neuromuscular paralysis

    • Comatose patients

  • Flail chest

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