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SPM200 -Skills Lab 6 Notes: Nasogastric Tube /

Oral Airways / O2 Deliery Deices


Artificial Airways
!""er airway obstructio# $ay occur %ro$ two sources: so%t tissue obstructio# &$ost
co$$o#' a#( lary#geal obstructio#)
1. Oropharyngeal Airway:
*#serte( i#to t+e $out+ betwee# t+e li" a#( teet+) *t e,te#(s %ro$ t+e li"s to t+e
"+ary#,) *t %ollows t+e #atural cure o% t+e to#gue) T+ey are $a(e o% "lastic a#(
are rigi() *t co#sist o% a %la#ge- bo(y a#( air c+a##el) Oro"+ary#geal airway is
(esig#e( to "ree#t t+e "atie#ts to#gue %ro$ %alli#g backwar( a#( obstructi#g +e
+y"o"+ary#,) *#(icatio#s: s"o#ta#eous- $a#ual- or $out+ to tube e#tilatio#)
Also- $ay be use( as a bite block %or "atie#ts t+at are orally i#tubate() *#
se$ico$atose or alert "atie#ts- Oro"+ary#geal airway $ay gag or i#(uce
o$iti#g a#( i#crease t+e risk o% as"iratio#) Ot+er co$"licatio# $ay be
lary#gos"as$- coug+i#g- a#( (e#tal (a$age)
To i#sert a# oro"+ary#geal airway usi#g t+e cross-%i#ger tec+#i.ue to o"e# t+e
"atie#ts $out+) O#e $et+o( o% i#sertio# is to tur# t+e airway /00 (egrees %ro$
its resti#g "ositio# as it is "asse( oer t+e to#gue to aoi( "us+i#g t+e to#gue
back i#to t+e "+ary#,) 1+e# t+e ti" o% t+e airway reac+es t+e uula- t+e airway is
rotate( /00 (egrees so t+at t+e ti" is "ositio#e( be+i#( t+e to#gue a#( %aci#g t+e
lary#,) A#ot+er $et+o( is i#serti#g t+e oral airway utili2i#g a to#gue (e"ressor
t+is allows you to (irectly isuali2e t+e "lace$e#t)
2. Nasopharyngeal Airway:
Naso"+ary#geal is a# alter#atie to oro"+ary#geal airway) *t is i#serte( i#to t+e
#ose a#( (irecte( alo#g t+e %loor o% t+e #asal "assage "arallel to t+e +ar( "alate)
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SPM200 -Skills Lab 6 Notes: Nasogastric Tube /
Oral Airways / O2 Deliery Deices
T+ey are $a(e o% so%t "lastic or rubber) To select t+e "ro"er le#gt+ o% t+e
#aso"+ary#geal airway- $easure t+e (ista#ce %ro$ t+e ti" o% t+e #ose to t+e
$eatus o% t+e ear)
3etter tolerate( i# se$i-awake "atie#t t+a# oral airways) *t eli$i#ates t+e risk o%
trau$a to t+e to#gue a#( teet+) !se( i# bro#c+osco"y a#( #asotrac+eal
suctio#i#g &trau$a')
1+e# i#serti#g a #aso"+ary#geal airway- %irst lubricate it wit+ a water-soluble
gel) *t is t+a# i#tro(uce( i#to o#e o% t+e #airs- a#( a(a#ce ge#tly to "ree#t
trau$a a#( blee(i#g) *% resista#ce is $et- try t+e ot+er #air)
4o$"licatio#s o% #aso"+ary#geal airways: lary#gos"as$ a#( coug+i#g i% too
lo#g)5 #oseblee(s5 (a$age turbi#ate5 si#us i#%ectio# &"rolo#g use')
Seere %acial trau$a - 4o#trai#(icatio#)

Oxygen Devices:
6oals o% i#creasi#g %ractio# o% i#s"ire( o,yge# &7*O
2
' t+era"y
/) *#crease o,yge# te#sio# i# aleolus/aleoli)
2) Possibly (ecrease t+e e#tilatory work #ecessary to $ai#tai# aleolar o,yge#)
8) Mai#tai# arterial o,yge# te#sio# to "ossibly (ecrease $yocar(ial work)
Types of Oxygen Devices:
I. Low-low 9 (elier o,yge# at %low rates usually #o greater t+a# 6 L/$i#-
i#su%%icie#t to $eet "atie#ts i#s"iratory %low (e$a#(s o% 80 L/$i#ute) T+e
re$ai#i#g i#s"ire( air is su""lie( by roo$ air)
Nasal !ann"la 9 $ost wi(ely use( to a($i#ister low-%low o,yge# to a(ults-
c+il(re# a#( i#%a#ts) 1ell tolerate( wit+ %low rates u" to 6 L/$i#) Delier 7*O
2

o% 2:; at /L/$i# a#( u" to about :0; at <-6L/$i#) 7or easy calculatio# o%
"erce#t 7*O
2
%or #asal ca##ula- $ulti"ly t+e liter %low by : a#( a(( it to 2/ = a#
a""ro,i$ate 7*O
2
&;') >,:

:&2 L/$i#' ? 2/ = 2@ ;'
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SPM200 -Skills Lab 6 Notes: Nasogastric Tube /
Oral Airways / O2 Deliery Deices
Non-re#reather $as% 9 *% t+is syste$ was "er%ect- it woul( (elier /00;
o,yge#) Aoweer- at %lows o% /0 to /< L/$i#- o#ly 7*O
2
o% 60 9 B0; are
ac+iee()
II. &igh-low 9 Meet t+e "atie#tCs %ull i#s"iratory %low (e$a#( a#( t+us $ai#tai# a
%i,e( 7*O
2
) T+ese (eices are u#a%%ecte( by c+a#ge i# res"iratory "atter# or
rate)
'ent"ri $as% 9 uses 3er#oulli "ri#ci"le5 e#trai#s roo$ air i# static "ro"ortio# to
o,yge# %low) T+ese (eices "roi(e +ig+ to total gas %lows o% %i,e( 7*O
2
)
De#turi $ask will "roi(e co#ce#tratio#s o% 7*O
2
betwee# 2:-<0;)
Ee%ere#ces:
/) Aess- Neil etc) &2002') Ees"iratory 4are: Pri#ci"les a#( Practice)
2) S+a"iro &/@B@') 4li#ical A""licatio# o% Ees"iratory 4are)
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