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Airway/CPR

8-25-2011 Airway Management

Last week we sent our tip out on bleeding. How you need to get that under control before you start or fix anything else.

A few weeks before we talked about Nasal airways.
After the leaks are stopped up its time to turn our attention to the next critical item that needs to be working for this engine to work

Breathing, the simple movement of air that we take for granted. We all breathe on an average 6 to 10 times a minute. When we are stressed or exerting ourselves we hit 15 to up to 30 times a minute.

This weeks Tip of the week is how to keep the induction system restarted and running.

In the old days of CPR, (2011) we did a ratio of 15 compressions and one breathe. That was with a 2 person team. With only one person we did it at 30 to 2. Come 2013 the breatheing portions were removed since it was determined that enough air could be moved by the compressions alone.

As we discussed in our last tip you have 4 minutes to get oxygen into someone. In a normal environment its pretty straight forward. Mask breathe., Done

Lets start with the basics:

To open the airway, gently lift the chin with one hand while pushing down on the forehead with your other hand.

You want to tilt the head back.

Once the airway is open, lean over and put your ear close to the victim’s mouth.

          Look

at the chest for movement.

          Listen

for the sound of breathing.

            Feel

for his breath on your cheek.

If none of these signs is present, the person isn’t breathing.

If opening the airway doesn’t cause the person to spontaneously start breathing, you’ll have to

provide rescue breathing. If the victim is breathing, roll the person onto his or her side as a unit.

Now lets look and see why this person isn’t breathing. Remember you have 4 minutes. From the TIME they STOPPED breathing.

The clock is running now.

Breathing for our patient is easy.. One of the surmised reasons it was removed from the CPR is that some felt that a contagious disease could be caught

So breathing is stopped. Holes are stopped up. Nothing is falling on you or your patient.
What has stopped their breathing?

We’ve spent a minute or so on checking things out. The clock is STILL running. We now are down to 2 minutes 30 to get oxygen into the body.

You’ve already done the look listen and feel Nothing is moving but a [pulse is there.

First start mouth to mouth. Do that for at least one minute and you know what has happened? You’ve bought yourself an extra 2 minutes or so. Now remember you can’t do this every time the clock runs down.

Now get something into them to help YOU breathe for THEM.

All us us should have a NPA in their blow out bag the Nasopharyngeal airway does help. But it has its limitation. It will not protect the airway of a person who is unconscious. By that I mean so down that you could remove their little finger and they wont wake up. That is where our buddy the OPA or oral pharyngealoral airway. It will hold the airway open and help you to get oxygen into the patient. BUT it has its limitations also. If the airway is damaged or if the bronchial passage are in such tight spasm the OPA will not help. This brings out the big guns of Airway management.

All hail The King

The King Airway is a modern approach to an old problem. Intubation with the traditional ET tubes is an EXPERTS ONLY PROCEDURE. Done with any mistake death WILL follow.

Enter the King tube. It was designed to be inserted by anyone with a basic level of reading comprehension.

The King tube is designed to be placed with out tools. And it is such that as long as the directions are followed, it is a simple procedure. Another advantage of the King tube vs ET tubes is it can be reused. In a SHTF this is important. The ET tube, will come apart when you try to sterilize it.

Another item that NEEDS to be in your major medic kit is the Bag Valve Mask or better know as the Ambu Bag. It will save more lives because it takes the effort out of breathing for someone.

One more item that is a MUST have is oxygen. However “medical” grade O2 is expensive and you need a prescription to get it. An alternative is to use Welding Oxygen.. It is simple to connect a nasal cannula or non rebreather Just cut the fitting off the end and the end off the cannula and just insert on to the other. Use the regulator to control the O2 and you have medical O2.

The art of getting someone to breathe on their own is something that cant be shared in a small tip. But the idea behind this is for YOU to take the time to research, read up on and or take a class from someone. And to PRACTICE the basics of Airway Management.

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