Advanced Medical Certification

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Assessing Airway

OPA through the mouth

Figure 10

Providers can postpone the insertion of an advanced airway if they believe that bag-mask ventilation is sufficient. The decision of where to place an advanced airway should be made during the ACLS Survey by health care providers. You must value this by weighing the benefit of a secure airway against the crucial importance of minimizing interruption, as placing the airway will require halting compressions temporarily.

Even the most basic airway equipment must include the nasopharyngeal airway (NPA) and the oropharyngeal airway (OPA). The difference here is where these airways are inserted—the NPA (Figure 10b) through the nose and the OPA (Figure 10a) through the mouth (Figure 10c and 10d). They both end in the pharynx. The NPA has the advantage over the OPA in that the device does not affect the gag reflex, meaning it can be used on both conscious and unconscious individuals.

An advanced set of airway equipment should include the endotracheal tube, esophageal-tracheal tube, laryngeal tube, and the laryngeal mask airway. You can also use more advanced airway equipment when available if this is within your expertise.

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