OXYGEN THERAPHY
DEVICES
BY
DEEPATH S .DOTT.,BSC AECT
NASAL CANNULA
NASAL PRONGS
NASAL CANNULA
NASAL CANNULA
NASAL CATHETER
NASAL CATHETER
NASAL CATHETER
SIMPLE FACE MASK
SIMPLE FACE MASK
SIMPLE FACE MASK
PARTIAL REBREATHING MASK
PARTIAL REBREATHING MASK
PARTIAL REBREATHING MASK
NON REBREATHING MASK
NON REBREATHING MASK
NON REBREATHING MASK
FLOW RATE
VENTURI MASK
VENTURI MASK
VENTURI MASK
VENTURI MASK
HIGH FLOW NASAL CANNULA
HIGH FLOW NASAL CANNULA
HIGH FLOW NASAL CANNULA
HIGH FLOW NASAL CANNULA
TRANSTRACHEAL CATHETER
TRANSTRACHEAL CATHETER
AIRWAY ADJUNCTS
ANATOMY OF URT
MANUAL AIRWAY MANOEUVRES
• The overall aim of basic airway manoeuvres is to lift the
tongue and soft tissues of the pharynx anteriorly to open
the airway
HEAD TILT, CHIN LIFT MANOEUVRE
JAW THRUST MANOEUVRE
THE TRIPLE MANOEUVRE
HEAD TILT,CHIN LIFT MANOEUVRE
• Place one hand on the patient’s forehead and the other under the chin
• Tilt the forehead back whilst lifting the chin forwards to extend the neck
HEAD TILT,CHIN LIFT MANOEUVRE
JAW THRUST MANOEUVRE
If the patient is suspected to have suffered significant trauma (with potential spinal
involvement) perform a jaw-thrust rather than a head-tilt chin-lift manoeuvre. Use both
hands to apply force behind the ramus of the mandible, displacing the lower jaw forwards
and upwards.
JAW THRUST MANOEUVRE
Jaw thrust step 1: Place two fingers under the angle of the mandible (on both
sides)
and anchor your thumbs on the patient's cheek
Jaw thrust step 2: Lift the mandible forwards
THE TRIPLE MANOEUVRE
• The “triple airway maneuver” is described by some authors as a valuable
method for maintaining a patent upper airway
• The most common description of this maneuver is head tilt, jaw thrust,
and mouth opening.
• Evidence demonstrates that the upper airway is more patent when the
mouth is closed.
• Although the triple maneuver is commonly mentioned in the anesthesia
literature as a valuable technique, no studies exist to support the
assertion that this technique is more effective than the head-tilt/chin-lift or
jaw-thrust maneuvers.
OROPHARYNGEAL AIRWAY[GUEDEL’S]
• An oropharyngeal airway can help prevent the tongue and soft
tissues of the pharynx from obstructing the airway.
• There are a variety of sizes available for children and adults. Size
a patient’s airway by measuring the Guedel against a patient’s
face: when the tip is placed at the angle of the jaw the flange
should align with the centre of the top teeth (i.e. hard airway =
measure “hard to hard”).
PARTS OF OPA
MEASUREMENT OF OPA
Insert the airway into the patient’s mouth upside down, pass to the back of the throat and rotate 180
degrees to fit behind the tongue base. In children, the Guedel should be inserted the right way up
(i.e. not upside down).
SIZE AND COLOURS
ISSUE WITH OPA
• They are poorly tolerated in conscious and semi-
conscious patients as it induces a gag reflex
• They can cause trauma to teeth and the mucous
membranes of the oral cavity
NASOPHARYNGEAL AIRWAY
• Nasopharyngeal airways (NPAs) are typically
used to bypass obstructions in the mouth,
nose, nasopharynx or base of the tongue.
PARTS OF NPA
SIZE OF NPA
MEASUREMENT AND TECHNIQUE
MEASUREMENT AND TECHNIQUE
• The appropriate NPA size can be calculated by measuring
from the tip of the patient’s nose to the tragus of the ear
(i.e. soft airway = measure “soft to soft”).
• To insert an NPA, lubricate the tip and insert it into the
right nostril aiming perpendicularly to the face to pass
along the nasal passage and down into the pharynx.
• The NPA tip should sit just above the epiglottis and the
flange should be at the tip of the nose.
ISSUE WITH NPA
• They should not be used in patients with suspected base
of skull fracture
• They can cause trauma to the nostril
AIRWAY
SUPRAGLOTTIC AIRWAY
• Supraglottic airways are a group of devices that sit abutting the
larynx, above the vocalcords. They are typically used as alternatives
to endotracheal airways in short or lowrisk anaesthetic cases
• They can also be used in prehospital and cardiac arrest settings to
achieve a more secure airway without endotracheal intubation.
• If placed in cardiac arrest, cardiac compressions do not need to be
interrupted as ventilation can be delivered simultaneously.
SUPRAGLOTTIC DEVICES
DEPENDING UPON GENERATION
FIRST GENERATION SECOND
GENERATION
SUPRAGLOTTIC
• Classic LMA DEVICES • Porseal LMA
• Flexible • I-GEL
LMA • Supreme LMA
• Cobra LMA THIRD
GENERATION
• Baska Mask
LMA POSITION
LMA PARTS
CLASSIC LMA
DETERMINE OF LMA
INSERTION TECHNIQUE
INDICATION FOR LMA
CONTRAINDICATION OF LMA
TYPES OF LMA(1ST GEN)
CLASSIC FLEXIBLE LMA COBRA LMA
LMA
TYPES OF LMA (2ND GEN)
TYPES OF LMA (2ND GEN)
LMA-FASTRAC LMA-CTRAC
LMA (3RD GEN)
INFRAGLOTTIC AIRWAY
• The infraglottic cavity is the portion of the larynx situated
inferior to the glottis, between the vocal cords and the
inferior border of the cricoid cartilage where it is
continuous with the trachea. Infraglottic devices create a
conduit between the mouth passing through the glottis,
and then into the trachea
• INFRAGLOTTIC DEVICES
ENDOTRACHEAL INTUBATION
TRACHEOSTOMY
BAG MASK VENTILATION
• BMV is the single most important technique for
emergency airway management. Bag-mask devices are
widely available and are standard equipment in all patient
care settings.
• Manually opening the airway, properly
position_x0002_ing the head and neck, placing an
oropharyngeal airway device, and achieving a tight face
mask seal are the keys to good BMV
BAG MASK VENTILATION
BMV TECHNIQUE
ENDOTRACHEAL INTUBATION
• Endotracheal intubation (EI) is often an emergency
procedure that’s performed on people who are
unconscious or who can’t breathe on their own. EI
maintains an open airway and helps prevent suffocation.
• The most common means of intubation in the emergency
setting is rapid-sequence intubation (RSI), and this
approach must be considered very carefully.
ET TUBE PARTS
DETERMINE OF ET TUBE SIZE
In, children <2yrs or above to be followed
formula
Uncuffed tube size (mm) = [Age (Yr)/4]+4
Cuffed tube size (mm) = [Age(Yr)/4]+3
ENDOTRACHEAL TUBE TYPES
COMBI TUBE RAE TUBE COLE TUBE
ENDOTRACHEAL TUBE TYPES
ENDOBRONCHIAL ET TUBE FLEXOMETTALIC TUBE
PRE INTUBATION CHECKLIST
INDICATION OF ET TUBE
CONTRAINDICATION OF ET TUBE
• Severe upper airway edema from burns, infection, or
anaphylaxis that may lead to laryngospasm if irritated
further.
• Airway-related complications:
Trauma to the lips, gums, teeth, or larynx
Laryngospasm or Bronchospasm
Perforation of the trachea
Hypoxia
LARYNGOSCOPE
• Despite the proliferation of approaches and devices
designed to secure a definitive airway, DL remains the
mainstay of tracheal intubation.
• DL is a crucial skill even in the era of video laryngoscopy,
and is less prone to problems such as device failure or
blood and secretions covering the video lens.
• Visual confirmation of the tube going through the vocal
cords is usually possible.
PARTS OF DL
LARYNGOSCOPE TYPES
DL &IDL LARYNGOSCOPE VIDEO LARYNGOSCOPE FLEXIBLE FIBRE OPTIC SCOPE
DL BLADE TYPES AND SIZES
MACINTOSH BLADE MILLER BLADE ROBERTSHAW BLADE
DL MCCOY BLADE
INDICATION OF DL
• INDICATION
Difficult Intubation
RTInsertion
Diagnostic purposes
CONTRAINDICATION OF DL
TRACHEAL TUBE INTRODUCER(BOUGIE)
• If DL does not bring the vocal cords fully into view, a
tracheal tube introducer may be used to facilitate
intubation. This adjunct is a long, thin, semirigid introducer
that, with the aid of a laryngoscope, is passed through the
laryngeal inlet and over which an ET tube is advanced
through the cords and into the trachea.
TRACHEAL TUBE INTRODUCER
BOUGIE STILLET GUIDE WIRE
TRACHEOSTOMY TUBE
• A tracheostomy tube is a medical device inserted into a
surgically created opening in the trachea, known as a
tracheostomy, to facilitate breathing. It provides direct
access to the lower airway, bypassing the nose and
mouth. Tracheostomy tubes are used for various reasons,
including prolonged ventilation, upper airway obstructions,
or secretion management.
TRACHEOSTOMY TUBE PARTS
TRACHEOSTOMY TUBE
INDIACTION OF TRACHEOSTOMY TUBE
• Acute Upper Airway Obstruction
• Chronic Upper Airway Obstruction
• To facilitate weaning from ventilator
• To reduce pulmonary aspirations
• Injury or posted head and neck surgery
• Neuromuscular Disorders
• Prolonged mechanical ventilation
• Burns
CONTRAINDICATIONS OF TRACHEOSTOMY
• Bleeding: Some bleeding is expected, but excessive bleeding can be a significant
complication.
• Pneumothorax: This is the presence of air between the lung and the chest wall, leading to
lung collapse.
• Injury to Surrounding Structures: Damage can occur to the esophagus, surrounding blood
vessels, or nerves.
• Tube Misplacement: The tube can be accidentally placed into the tissue between the
tracheal rings or into the esophagus.
• Subcutaneous Emphysema: Air can accumulate under the skin around the tracheostomy
site, causing swelling and discomfort.
• Air Embolism: Rarely, air can enter the bloodstream, which can be life-threatening.
• Infection: Infections can develop at the tracheostomy site.
• REFERENCE :
Roberts and Hedges CLINICAL PROCEDURE in Emeregency
Medicine and Acute Care-7th Edition
