Advanced Trauma Life Support ATLS Student Course Manual 2018
Skill Station A AIRWAY Part 1: Basic Airway Skills • Insertion of Nasopharyngeal Airway • Safe Use of Suction • Insertion of Oropharyngeal Airway • One-Person Bag-Mask Ventilation • Two-Person Bag-Mask Ventilation Part 3: Pediatric Airway and Cricothyrotomy • Infant Endotracheal Intubation • Needle Cricothyrotomy • Surgical Cricothyrotomy Part 2: Advanced Airway Management • Insertion of Laryngeal Mask Airway (LMA) • Insertion of Laryngeal Tube Airway (LTA) • Oral Endotracheal Intubation LEARNING OBJECTIVES Part 1: Basic Airway Skills 1. Assess airway patency in a simulated trauma patient scenario. 2. Apply a non-rebreathing mask to maximize oxygenation. 3. Apply a pulse oximeter. 4. Perform a jaw thrust on a manikin to provide an adequate airway. 5. Demonstrate airway suctioning on a manikin. 6. Insert a nasopharyngeal airway and oropharyngeal airway on a manikin. 7. Perform one-person and two-person bag-mask ventilation of a manikin. Part 2: Advanced Airway Management 1. Insert a supraglottic or extraglottic device on a manikin. 2. State the indications for a definitive airway. 3. Attempt oral endotracheal intubation on a manikin. Part 3: Pediatric Airway and Cricothyrotomy 1. Review basic management of the pediatric airway. 2. Attempt infant endotracheal intubation on a manikin. 3. Identify the anatomic landmarks for cricothyroidotomy. 4. Perform a needle cricothyrotomy and describe the options for oxygenation. 5. Perform a surgical cricothyrotomy on a model. n BACK TO TABLE OF CONTENTS 337
338 APPENDIX G n Skills Part 1: Basic Airway Skills Skills Included in this Skill Station •• Insertion of Nasopharyngeal Airway (NPA) •• Safe Use of Suction •• Insertion of Oropharyngeal Airway and Reassessment •• One-Person Bag-Mask Ventilation •• Two-Person Bag-Mask Ventilation Insertion of Nasopharyngeal Airway (NPA) Note: Do not use a nasopharygeal airway in a patient with midface fractures or suspected basilar skull fracture. STEP 1. Assess the nasal passages for any apparent obstruction (e.g., polyps, fractures, or hemorrhage). STEP 2. Select the proper size of airway. Look at the nostril diameter to determine the greatest size that will pass easily through the nostril. STEP 3. Lubricate the nasopharyngeal airway with a water-soluble lubricant or tap water. STEP 4. With the patient’s head in neutral position, stand to the side of the patient. Holding the NPA like a pencil, gently insert the tip of the airway into the nostril and direct it posteriorly and toward the ear. STEP 5. Gently insert the nasopharyngeal airway through the nostril into the hypopharynx with a slight rotating motion, until the flange rests against the nostril. If during insertion the NPA meets any resistance, remove the NPA and attempt insertion on the other side. If the NPA causes the patient to cough or gag, slightly withdraw the NPA to relieve the cough or gag and then proceed. STEP 6. Reassess the patient to ensure that the airway is now patent. Safe Use of Suction STEP 1. Turn on the vacuum, selecting a midpoint (150 mm Hg) rather than full vacuum (300 mm Hg). STEP 2. Gently open the mouth, inspecting for bleeding, lacerations or broken teeth. Look for the presence of visible fluid, blood, or debris. STEP 3. Gently place the suction catheter in the oropharynx and nasopharynx, keeping the suction device (Yankauer) tip in view at all times. Insertion of OrophARyngeal Airway (opA) (airway cleAR) STEP 1. Select the proper size of airway. A correctly sized OPA device extends from the corner of the patient’s mouth to the earlobe. STEP 2. Open the patient’s mouth with the crossedfinger (scissors) technique. STEP 3. Insert a tongue blade on top of the patient’s tongue and far enough back to depress the tongue adequately. Be careful not to cause the patient to gag. STEP 4. Insert the airway posteriorly, gently sliding the airway over the curvature of the tongue until the device’s flange rests on top of the patient’s lips. The device must not push the tongue backward and block the airway. An alternate technique for insertion, termed the rotation method, involves inserting the OPA upside down so its tip is facing the roof of the patient’s mouth. As the airway is inserted, it is rotated 180 degrees until the flange comes to rest on the patient’s lips and/or teeth. This maneuver should not be used in children. STEP 5. Remove the tongue blade. STEP 6. Reassess the patient to ensure that the airway is now patent. n BACK TO TABLE OF CONTENTS
- Page 338 and 339: 285 APPENDIX C n Trauma Care in Mas
- Page 342 and 343: Appendix D DISASTER PREPAREDNESS AN
- Page 344 and 345: 291 APPENDIX D n Disaster Preparedn
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- Page 352 and 353: Pitfall Inadequate security Failed
- Page 356 and 357: Appendix E ATLS AND TRAUMA TEAM RES
- Page 358 and 359: 305 APPENDIX E n ATLS and Trauma Te
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- Page 370 and 371: Appendix F TRIAGE SCENARIOS OBJECTI
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- Page 392 and 393: 339 APPENDIX G n Skills One-Person
- Page 394 and 395: 341 APPENDIX G n Skills STEP 5. Con
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- Page 399 and 400: 346 APPENDIX G n Skills STEP 1. D
- Page 402 and 403: Skill Station C CIRCULATION LEARNIN
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- Page 411 and 412: 358 APPENDIX G n Skills A. Note fac
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- Page 419 and 420: 366 APPENDIX G n Skills n FIGURE G-
- Page 421: 368 APPENDIX G n Skills less than 1
- Page 425 and 426: 372 APPENDIX G n Skills G. Inspect
- Page 427: 374 APPENDIX G n Skills in the inju
- Page 431 and 432: 378 INDEX LTA for, 31-32, 32f Malla
- Page 433 and 434: 380 INDEX atlanto-occipital disloca
- Page 435 and 436: 382 INDEX Frostbite, 181-183, 182f
- Page 437 and 438: 384 INDEX Kussmaul’s sign, 69 Lac
Skill Station A<br />
AIRWAY<br />
Part 1: Basic Airway Skills<br />
• Insertion of Nasopharyngeal Airway<br />
• Safe Use of Suction<br />
• Insertion of Oropharyngeal Airway<br />
• One-Person Bag-Mask Ventilation<br />
• Two-Person Bag-Mask Ventilation<br />
Part 3: Pediatric Airway and<br />
Cricothyrotomy<br />
• Infant Endotracheal Intubation<br />
• Needle Cricothyrotomy<br />
• Surgical Cricothyrotomy<br />
Part 2: <strong>Advanced</strong> Airway Management<br />
• Insertion of Laryngeal Mask Airway (LMA)<br />
• Insertion of Laryngeal Tube Airway (LTA)<br />
• Oral Endotracheal Intubation<br />
LEARNING OBJECTIVES<br />
Part 1: Basic Airway Skills<br />
1. Assess airway patency in a simulated trauma patient<br />
scenario.<br />
2. Apply a non-rebreathing mask to maximize<br />
oxygenation.<br />
3. Apply a pulse oximeter.<br />
4. Perform a jaw thrust on a manikin to provide an<br />
adequate airway.<br />
5. Demonstrate airway suctioning on a manikin.<br />
6. Insert a nasopharyngeal airway and oropharyngeal<br />
airway on a manikin.<br />
7. Perform one-person and two-person bag-mask<br />
ventilation of a manikin.<br />
Part 2: <strong>Advanced</strong> Airway Management<br />
1. Insert a supraglottic or extraglottic device on a manikin.<br />
2. State the indications for a definitive airway.<br />
3. Attempt oral endotracheal intubation on a manikin.<br />
Part 3: Pediatric Airway and Cricothyrotomy<br />
1. Review basic management of the pediatric airway.<br />
2. Attempt infant endotracheal intubation on a manikin.<br />
3. Identify the anatomic landmarks for cricothyroidotomy.<br />
4. Perform a needle cricothyrotomy and describe the<br />
options for oxygenation.<br />
5. Perform a surgical cricothyrotomy on a model.<br />
n BACK TO TABLE OF CONTENTS<br />
337
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