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Emergency Airway and Ventilation—The Difficult Airway By: Darryl Jamison NREMT-P Hey ya’ll watch this…. Goals Predict a difficult airway based on clinical criteria Plan for appropriate action in the difficult airway Initiate appropriate plans of attack with confidence in the “Can’t Ventilate/Cant Intubate” (CVCI) situation Become informed about some new (and not so new) airway options out there. What this class assumes You already understand the basic anatomy of the Airway You already have a basic understanding of both BLS airway maneuvers and Endotracheal Intubation by Oral and Nasal means You are familiar with needle and traditional surgical airway procedures. You are an experienced operator in the field of EMS. Function of the Respiratory System Pulmonary ventilation—movement of air into and out of lungs so that gases in the alveoli are continuously exchanged. External respiration—gas exchange between blood and alveoli Transport of respiratory gases—02 and CO2 between lungs and tissue Internal respiration—gas exchange between systemic blood and tissue cells Why do we Intubate? Inability to protect and maintain patent airway. Failure of oxygenation or ventilation. Anticipated need based on clinical course Ideal conditions for intubation Ideal Lighting, positioning, etc. Plenty of assistance Time to prepare, plan, discuss Option to Abort Empty Stomach Back up available. Ideal Pt. for intubation Intact, clear airway Wide open mouth Pre-Oxygenated Intact respiratory drive Normal dentition/good oral hygiene Clearly identifiable and intact Neck and Face Big open Nostrils Good Neck Mobility Greater than 90 KG, Less than 110 kg. Ped and Adult Normal Trachea0 In Reality Our patients are: Immobilized Traumatized Compromised Prioritized Beer-n-Pizza-ized They Tend to look like This: Or this… Or this (after failed ETT) Most of our Patients are already “difficult airways” by “OR” Standards. Why should EMS personnel try to further identify a dif