aplsairway and breathing (vn)

Airway and Breathing Advanced Paediatric Life Support CÊp cøu Nhi khoa N©ng cao... §­êng­thë­vµ­thë - Môc­tiªu• N¾m ® îc c¸ch tiÕp cËn trong håi søc ® êng thë vµ thë Airway and Breathi

Airway and Breathing

Advanced Paediatric Life Support

CÊp cøu Nhi khoa N©ng cao

§­êng­thë­vµ­thë - Môc­tiªu

• N¾m ® îc c¸ch tiÕp cËn trong håi søc

® êng thë vµ thë

Airway and Breathing - Objectives

To understand the structured approach to airway and breathing

To introduce the equipment used

To describe the skills to be acquired

Oropharyngeal airway

• (Cỡ) - Giữa miệng đến góc hàm

Size - centre of the mouth

to angle of the jaw

Insertion - Tongue depression

Đườngưthởưvàưthở - Đườngưhầuưhọng

Nasopharyngeal airway

• Dài từ mũi đến bình tai

Size-length tip of the nose

to the tragus of the ear

Insertion LubricateDirect posteriorGentle rotation

Intubation - Tracheal tubes

Intubation - laryngoscopes

Size of the blade

Shape of the blade

ĐặtưốngưNKQư- Đènưsoiưthanhưquản

• Hình dạng l ỡi đèn

Intubation - Sequence

Check and arrange equipmentSelect the tubes

Intubation after insertion

Confirm position clinically

Check for leaks

Secure the tube

Use CO2 monitoring device

Cung cấp oxy tr ớc, sau

đặt NKQ và sau khi không đặt đ ợc NKQ

Oxygenate BEFORE AND AFTER INTUBATION AFTER FAILED INTUBATION

Needle cricothyroidotomy

Check and arrange equipment

Surgical airway

Chỉ định chỉ cho trẻ sau tuổi dậy thì

Post pubertal children only

Phẫuưthuậtưđườngưthở

Surgical Airway - Complications

PhÉu­thuËt­®­êng­thë­-­

PhÉu­thuËt­®­êng­thë­-­BiÕn­chøng

• Sai ® êng vµo False passage

• ChÊn th ¬ng ¸p lùc Barotrauma

• Thñng thùc qu¶n Oesophageal perforation

• Viªm m« tÕ bµo Cellulitis

• HÑp h¹ thanh m«n Subglottic stenosis

Breathing - Basic resuscitation

Thë­-­Håi­søc­c¬­b¶n

Breathing - Enhanced oxygen

Thởư-ưôxyưtăngưcường

Phải cho thở nồng độ oxy cao nhất

Breathing Ventilation - Self inflating bag

Th«ng­khÝ­-­Bãng­tù­phång

Breathing Ventilation - open ended bag

Th«ng­khÝ­-­Bãng­më­mét­®Çu

Breathing Ventilation - cricothyroidotomy

Increased by 1 litre increments

until chest rises

• 1 gi©y thë vµo; 4 gi©y thë ra

1 second insufflation; 4 seconds exhalation

§ êng thë vµ thë ? ?

Advanced Paediatric Life Support

CÊp cøu Nhi khoa N©ng cao

Airway and Breathing - Summary

Open and clear the airway

• §Æt èng NKQ nÕu cÇn Intubate when necessary

• PhÉu thuËt ® êng thë lµ ph ¬ng

s¸ch cuèi cïng

Surgical airway can be

a last resort

• Th«ng khÝ nÕu cÇn Ventilate as necessary

• Theo dâi hiÖu qu¶ Monitor effectiveness