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Airway Management for the BLS Provider
29
A Day In The Life of Mr. Trey
Presented by Briana Pervaiz, NRP, CCEMT-P
First Impressions?
Airway Anatomy
Upper Airway
Lower Airway
Levels of Distress
Causes of Dyspnea and Possible Associated Symptoms
ASTHMA
PROLONGED SEIZURES
1
12
Wheezing/No air movement heard
AMS
ANAPHYLAXIS
2
AIRWAY OBSTRUCTION
13
Flushed skin/hives, generalized edema, laryngeal edema
PULMONARY EMBOLISM
BRONCHITIS
14
3
Chronic productive cough, wheezing, cyanosis
Chest pain, hemoptysis, cyanosis
HYPERVENTILATION
CHF
4
15
Dependent edema, rales, cough, possibly pink and frothy sputum, JVD
ENVIRONMENTAL/INDUSTRIAL EXPOSURE
CROUP
16
5
Fever, barking cough, mostly pediatrics
COLD/FLU
EMPHYSEMA
17
6
Barrel chest, pursed lip breathing, dyspnea upon exertion
TUBERCULOSIS (TB)
18
PNEUMONIA
7
Fever, productive cough, fatigue, bloody sputum, chest pain,
Fever, cough, dark sputum
EPIGLOTTITIS
PNEUMOTHORAX
19
8
Fever, sore throat, stridor, drooling,
Sudden chest pain with dyspnea, decreased lung sounds on affected side, tracheal deviation, JVD
RSV
20
PERTUSSIS (WHOOPING COUGH)
9
Cough, sneezing
Cough, fever, mostly pediatrics
SARS
COPD
21
10
Flu like symptoms which can progress
Shortness of breath mostly from exertion, cough, sputum
MENINGOCOCCAL MENINGITIS
PLEURAL EFFUSION
22
11
Flu like symptoms, fever, headache, photophobia, stiff neck
Decreased breath sounds over affected side
Always treat the patient! Consider SAMPLE, OPQRST, PASTE (Progression, Associated chest pain, Sputum, Talking tiredness, Exercise tolerance), and vitals when evaluating your patient as well to narrow down causes and treatment.
Airway Delivery Devices
First Steps? Treatment?
Ummm... Mr. Trey?
OPA/NPA
Cheostomy
Mr. Trey...
Venturi Mask For Trachs
Suctioning Trachs
BVM with Trachs
Trey Jr.
Nebs/Albuterol
Albuterol dose
- Adults: 2.5 mg nebulized with 6-8lpm of O2. Repeat once.
- Peds: Repeat once
2 or older: 2.5mg nebulized
less than 2: 1.25mg nebulized
- Additional dose requires med consult
Epinephrine 1:1
Epinephrine dose for:
- Anaphylaxis/Severe Asthma:
- less than 5: 0.15mg in 0.15ml IM lateral thigh
- 5 or older: 0.5mg in 0.5ml IM lateral thigh
- Additional doses require med consult
Sources
- National Heart, Lung, and Blood Institute. National Asthma Education and Prevention Program Expert Panel Report 2:Guide-lines for the diagnosis and management of asthma. Publication No. 97–4051. Bethesda: National Institute of Health;1997.
- https://careflightcollective.com/2017/04/30/i-wish-i-knew-then-what-i-know-now-simple-airway-management/
- 2024 MD Medical Protocol, MIEMSS
- Emergency: Care and Transportation of the Sick and Injured by Jones and Bartlett, Edited by A. Pollack, L. Barnes, J. Ciotola, and B. Gulli