Doctors News Hubb
Advertisement Banner
  • Home
  • News
  • Healthcare
  • Public Health
  • Paramedic
  • Nursing
  • Contact Us
No Result
View All Result
  • Home
  • News
  • Healthcare
  • Public Health
  • Paramedic
  • Nursing
  • Contact Us
No Result
View All Result
Doctors News Hubb
No Result
View All Result
Home Paramedic

What You Need to Know

admin by admin
March 7, 2023
in Paramedic


127987377_l - Copy

In a perfect world, a patient will be sedated before intubation, but as emergency care providers understand, conditions often are not optimal and other approaches are necessary.

 

 

Awake tracheal intubation (ATI), placing an airway device in the trachea of a patient who is awake and breathing, can be a successful and safe option for patients with an anticipated difficult airway, a history of intubation struggles or a weak cervical spine. Nevertheless, it requires experience and focus to correctly perform.

 

Knowledge is key

 

Knowing how to properly execute an ATI will allow for a quick and efficient way to help a patient suffering an airway or respiratory emergency. Previous research claims that having two anesthesia providers is key: one to perform the procedure and one to monitor the patient.

 

Using visual aids, such as checklists when time allows, improves the overall consistency and communication among medical teams. According to the Difficult Airway Society (DAS), the main practical elements of a successful ATI can be broken down into four categories:

 

  • Oxygenation
  • Topicalization
  • Sedation
  • Performance

 

Oxygenation

 

It is highly recommended to administer oxygen to patients during ATI. Oxygen should be given immediately upon arrival, and the distribution of oxygen to the patient should be continued throughout the entire ATI process. Oxygen masks can be used for this, but the most optimal technique would be the use of high-flow nasal oxygen.

 

Topicalization

 

To ensure the success of an ATI procedure, the topical application of local anaesthetic must be spot-on. It is best practice to use 20 to 30 initial sprays during inspiration.

 

Vasoconstriction of the nasal passage, what MedlinePlus describes as blood vessels constricting, can decrease the patient’s chance of bleeding from their nose. A variety of topical nasal decongestants can increase airflow and reduce blockages, and it is recommended that these be used prior to nasotracheal intubation.

 

Sedation

 

Although sedation is not required during ATI, minimal sedation is sometimes recommended and encouraged to reduce the patient’s anxiety. Minimal sedation is a drug-induced state where the patient can respond to verbal commands, and the airway, ventilation and cardiovascular functions remain unaffected. There is always a chance of over-sedation, especially within certain age demographics, which is why it is strongly recommended the administration of sedation be done by a trained, independent practitioner, if possible.

 

Tracheal tube placement check

 

Without the proper tube placement, ATI can be ineffective. The two ways to check that the tracheal tube is in the proper place are:

 

  1. The practitioner must visualise the tube going through the vocal cords.
  2. The practitioner can perform a capnography to confirm proper tracheal tube placement. This can be done by measuring the respiratory rate and carbon dioxide exchange with each breath.

 

This step should also be done while the patient is sitting up, and the operator should ensure they can see the patient’s monitor, video screen and any infusion pumps the patient may have.

 

SALAD

 

A vital piece of any intubation procedure is for the provider to set themselves and patient up for success before the process begins. Be prepared to utilize the Suction Assisted Laryngoscopy and Airway Decontamination, or the SALAD technique. It uses aggressive suction, ideally with a specifically designed catheter, to quickly clear the airway prior to intubation. Read more about the technique here. Given that intubation failure is possible for even veteran providers, this is a crucial step.

 

Effective ATI leads to safer care

 

With proper knowledge and practical experience, ATI can be a safer and easier option for patients because spontaneous ventilation and intrinsic airway tone are maintained throughout the process. Medical professionals educating themselves and keeping a checklist of proper procedures on-hand can save someone’s life.

 

SSCOR VX-2 Portable and Onboard Suction

 



Source link

Advertisement Banner
Previous Post

House investigating PBMs Caremark, Express Scripts, OptumRx

Next Post

Later Neurodevelopmental and Health Outcomes in the Growth After Extremely Preterm Births

Related Posts

Paramedic

How to Clear A Clogged Suction Tip: A Step-by-Step Guide

March 26, 2023
Paramedic

How to Recognize Respiratory Emergencies Before They Happen

March 24, 2023
Paramedic

Stress Management for First Responders

March 22, 2023
Paramedic

What Hospital Emergency Operations Plans Should Say About Power Loss

March 19, 2023
Paramedic

3 Pediatric Suction Scenarios You Will Likely Encounter

March 17, 2023
Paramedic

Managing An Actively Bleeding Airway

March 13, 2023
Next Post

Later Neurodevelopmental and Health Outcomes in the Growth After Extremely Preterm Births

Recommended

Why race equity plans matter and how to report on them

3 months ago

Is Surgical Excision of Parameatal Urethral Cyst Necessary in Children?

5 months ago

Panelists endorse collaborative ‘prebunking’ to stop toxic misinformation 

2 weeks ago

America, the intolerant – The Health Care Blog

4 months ago

Reporters shed light on unsubstantiated drug price increases 

3 months ago

© 2022 Doctors News Hubb All rights reserved.

Use of these names, logos, and brands does not imply endorsement unless specified. By using this site, you agree to the Privacy Policy and Terms & Conditions.

Navigate Site

  • Home
  • News
  • Healthcare
  • Public Health
  • Paramedic
  • Nursing
  • Contact Us

Newsletter Sign Up.

No Result
View All Result
  • Home
  • News
  • Healthcare
  • Public Health
  • Paramedic
  • Nursing
  • Contact Us

© 2022 Doctors News Hubb All rights reserved.