Anesthesia Clinical Rotation 2007Female Group E1I've made this note depending on my notes I wrote during the rotation .. Hope you find it helpful & useful .. Wish you all the best & don't forget me from your prayers .. Best of luck in the exam Iman A. Al-MukhtarAir wa Mana!ement.. Air wa "#struction$ %i!ns o& Air wa "#struction in non-intu#ate' patients $ ! "oisy Breathing #he commonest sign . $ ! %sing the accessory respiratory muscles . & ! By 'uscultation ( une)ual air entry to both lungs . * ! 'ir hunger & distress .+ ! ,yanosis in sever or prolonged obstruction . Common Causes o& Air wa "#struction in non-intu#ate' patients ! "asal ,avity -bstruction . e.g ( .eviated "asal /eptum . $ ! -ral ,avity -bstruction . e.g ( #ongue 0all against the posterior pharyngeal wall . it is the commonest cause . & ! 1aryngeal /pasm . e.g ( 1aryngitis .. * ! #racheal & Bronchi -bstruction . e.g ( 0oreign Body 2 Hyperactive air way 3 full of secretions 3 Common Causes o& Air wa "#struction in intu#ate' patients $ ! High air way pressure #he commonest cause . $ ! 4echanical -bstruction . e.g ( Blood clot 2 secretary bluge . & ! 5hysiological -bstruction . e.g ( 'sthma induced bronchospasm . #here in "- "oisy Breathing in intubated patients . (ow to make patent Air wa ) Head 1ift in non! traumati6e patients7aw #hrust in traumati6e patientsAir wa Instruments .. * 1 + "ropharn!eal Airwa$In'ication$,pper Air wa "#struction mainl # ton!ue &all . Contrain'ications $ 1 - %emiconscious patient . * #c- it will stimulate !a! re&le. causin! /omitin! 0 aspiration + 2 - 1atient with multiple man'i#le &ractures .2 - 1atient with multiple ton!ue in3uries .2 - 1atient with har' teeth clenchin! .* 2 + 4asopharn!eal Airwa$In'ication$,pper Air wa "#struction 0 the patient 'oesn5t &it &ororopharn!eal air wa insertion . Contrain'ications $ 1 - 6asal %kull Fracture 7 A#solute Contrain'ication 7 otherwise ou will insert it to the #rain 0 cause se/er uncontrolla#lecomplications .2 - Epista.is . 2 - 8e/iate' 4asal %eptum or other nasal 'e&ormit . 9 - Fracture 4ose . : - 4asal In&ection . * 2 + C"1A + Cu&&e' "ropharn!eal Airwa$ + It is an "ropharn!eal Airwa with a cu&& to pre/ent an air leak .

* 9 + ;arn!eal Mask Airwa + ;MA $ + Insert the mask in front of the larynx to ventilate the patient . #here are many si6es 8 for adults & neonates 9 %se the largest si6e that your patient can accommodate . A'/anta!es$ ! .oesn't need an expert to insert it . $ ! :asley administered . 8isa'/anta!e$.oesn't prevent aspiration . It is not the ideal ventiltory device . It is used for life saving cases . ,an be used electively in -; patients E.press$ +It is a modified laryngeal tube with wider opening . 8isa'/anta!e$#his most traumati6ing airway device 99 * 7 + Com#