MAN

1
MAN

• Marshall Airway Nasopharyngeal

2
Introduction

• Patients undergoing resuscitation often have an
  obstructed airway
• This is usually as a result of loss of
  consciousness and it can also be the primary
  cause of unconsciousness
• Prompt assessment, control of the airway and
  provision of ventilation is essential
• This will help to avoid secondary hypoxic damage
  to the brain and other vital organs.
• Without adequate oxygenation it may be
  impossible to restart an arrested myocardium.
• BLUE HEARTS DONT START

3
The causes of Airway Obstruction

• Obstruction of the airway may be partial or
  complete and can
• occur at any level from the nose and mouth down
  to the bronchi.
• Pharyngeal obstruction (the most common) can be
  caused by-
• Loss of muscle tone allowing the tongue and
  surrounding tissue to occlude the airway
• Vomit or Blood
• Regurgitation of gastric contents
• Trauma
• Foreign bodies
• Laryngeal obstruction can be caused by-
• Oedema from burns
• Inflammation
• Anaphylaxis
• Laryngeal Spasm
• Obstruction below the larynx is the least common
  and can be caused by-
• Excessive bronchial secretions
• Mucosal Oedema

4
Recognition of Airway Obstruction

• LOOK for chest and abdominal movements
• LISTEN and FEEL for airflow at nose and mouth
• In partial airway obstruction air inspiration is
  diminished and NOISY
• Wheezing suggests obstruction of the lower
  airways
• Stridor suggests obstruction at the laryngeal
  level or above
• Gurgling is indicative of liquid material in the
  main airways
• Snoring occurs when the pharynx is partially
  covered by tongue or palate
• Crowing is the sound of laryngeal spasm or
  obstruction
• SEE-SAW breathing (Paradoxical Breathing) which
  isan asynchronous rising of chest and
  abdomen,can occur when a patient with complete
  airway obstruction is attempting to breathe

5
When Listening for Airflow

• Normal Breathing should be quiet
• COMPLETELY OBSTRUCTED breathing is silent
• Noisy breathing indicates partial obstruction
• Unless the airways are cleared within a very few
  minutes, neurological and other vital organs will
  be injured leading to cardiac arrest

6
Basic Techniques for Opening the Airway

• Immediate measures must be taken once
  obstruction has been detected
• There are 3 manoeuvres which can be used to
  create a clear airway
• Head Tilt (Not recommended for trauma)
• Chin Lift (Not recommended for trauma)
• Jaw Thrust

7
Basic Airway techniques

• The oropharyngeal and nasopharyngeal airways-
• Can be used to maintain an open airway
  (especially if resuscitation is prolonged)
• Are designed to overcome backward tongue
  displacement in an unconscious patient
• Head tilt and jaw lift may also be required

8
Nasopharyngeal Airway

• Made from soft malleable plastic
• Bevelled at one end
• Flange at other end
• Available in adult sizes

BETTER TOLERATED THAN OROPHARYNGEAL AIRWAYS in
patients who are NOT deeply unconscious LIFE
SAVING in patients with clenched jaws, trismus
or with maxillofacial injuries NOT RECOMMENDED if
there is a suspicion of base of skull fracture
as there has been one case of a nasopharyngeal
airway being inserted into the cranial vault
through a fracture.
9
Insertion InstructionsNasopharyngeal Airway

• Check for patency of right nostril
• Some older designs (NOT Marshall Airway
  Nasopharyngeal) require a safety pin to be
  inserted through the flange to keep the flange
  outside the nostril
• Lubricate the airway thoroughly using water
  soluble jelly
• Insert the airway bevel end first, vertically
  along the floor of the nose with a slight
  twisting action
• The curve of the airway should direct it towards
  the patients feet
• If any obstruction is met remove the tube and try
  the left nostril
• Once in place check for patency of the airway
• Check for adequate ventilation using look listen
  feel
• Chin lift or jaw thrust may still be required to
  maintain the airway
• Where there is suspicion of an injury to the
  cervical spine, maintain correct alignment and
  immobilisation of head and neck

10
Ordering Information
Marshall Products Limited 13 Ferry Court Ferry
Lane Bath BA2 4JW t0845 612 8888 f0845 612
8889 sales_at_marshallproducts.co.uk www.marshallprod
ucts.co.uk
11
MAN
Marshall Airway Nasopharyngeal