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Airway management is a primary consideration in the fields of cardiopulmonary resuscitation, anaesthesia, emergency medicine, intensive care medicine, neonatology, and first aid. The "A" in the ABC treatment mnemonic is for airway.
Basic airway management is a concept and set of medical procedures performed to prevent and treat airway obstruction and allow for adequate ventilation to a patient's lungs. [1] This is accomplished by clearing or preventing obstructions of airways. Airway obstructions can occur in both conscious and unconscious individuals.
Advanced airway management is the subset of airway management that involves advanced training, skill, and invasiveness. It encompasses various techniques performed to create an open or patent airway – a clear path between a patient's lungs and the outside world. This is accomplished by clearing or preventing obstructions of airways.
In 2010, the American Heart Association and International Liaison Committee on Resuscitation changed the recommended order of CPR interventions for most cases of cardiac arrest to chest compressions, airway, and breathing, or CAB. [3]: S642 [4]
Opening of the airway via the jaw-thrust maneuver is the preferred method as the head-tilt maneuver is thought to be more risky for people with suspected spinal injury or inconveniency. If the person is in danger of pulmonary aspiration then they should be placed in the recovery position or more advanced airway management should be used.
The first stage of the primary survey is to assess the airway. If the patient is able to talk, the airway is likely to be clear. If the patient is unconscious, he/she may not be able to maintain his/her own airway. The airway can be opened using a chin lift or jaw thrust. Airway adjuncts may be required.
[4] [5] However, traditional airway management education has not included the integration of a simultaneous suctioning and airway decontamination skill set as a technique that can be deployed in the setting of large volume contamination and clinicians frequently underestimate the importance of suction as part of airway management. [1] [6] [7]
The result was a four-part, front-page series that ran from October 23 to 26, 2005, entitled Critical Care: The making of an ICU nurse. [10] The added psychological stress of nursing in critical care units has been well-documented, and it has been argued the stress experienced in ICU areas are unique in the profession. [11]