Advanced Medical Certification

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Basic Intubation Technique

Inserting an OPA

STEP 1

Clean blood and secretions from the mouth with suction.

STEP 2

Choose an appropriately sized airway device.

  • Too large and you risk damaging the throat.
  • Too small and you risk forcing the tongue into the airway.

STEP 3

The device must be placed beside the person’s face. Extend the device from the earlobe to the corner of the mouth.

STEP 4

The device must be positioned in the mouth so that the tip is pointed towards the mouth’s roof or in line with the teeth.

  • Make sure the tongue is NOT pushed to the throat

STEP 5

When the device is almost completely inserted, twist it until the tongue is cupped inside by the curve of the device.

Inserting an NPA

STEP 1

Chose an appropriately sized airway device.

STEP 2

The device must be placed beside the person’s face. It must extend from the earlobe to the tip of the nose. Make sure to apply the largest diameter device that can fit.

STEP 3

Use a water-soluble lubricant or possibly an anesthetic jelly when available to lubricate the airway.

STEP 4

The device must move into the face, not toward the brain, and must be inserted slowly.

STEP 5

There should be a snug fit, but the device should not be forced into the nostril. Try the other nostril if the device feels stuck.

TIPS ON SUCTIONING

  • When suctioning the oropharynx, do not insert the
    catheter too deeply. Extend the catheter to the maximum safe depth and suction as you withdraw.
  • When suctioning an endotracheal (ET) tube, keep in
    mind the tube is within the trachea and that you may
    be suctioning near the bronchi or lung. Therefore,
    sterile technique should be used.
  • Each suction attempt should be for no longer than 10
    seconds. Remember the person will not get oxygen
    during suctioning.
  • Ideally, hyper oxygenate before any suction attempts
    to eliminate that oxygen loss
  • Monitor vital signs during suctioning and stop suctioning immediately if the person
    experiences hypoxemia (oxygen sats less than 94%),
    has a new arrhythmia or becomes cyanotic.
Take Note
  • OPAs that are too large or small may obstruct the airway.
  • NPAs that are an incorrect size may enter the esophagus.
  • Make sure you check for spontaneous respirations after insertion of either device.

Advanced Cardiac Life Support (ACLS) Recertification Course

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