UNCONTROLLED WHEN PRINTED
Indications
  • Advanced airway management is the assessment and protection of a compromised airway via the use of techniques such as patient positioning, suction, oropharyngeal, supraglottic and surgical airway (Cricothyrotomy).
  • Endotracheal intubation is de-emphasised and should not occur un-necessarily
  • A Vortex-like approach should be utilised for a considered and structured management approach in:
    • Cardiac arrest patients
    • Patients with an unprotected airway that has risk of compromise:
    • A-reflexic patients with a GCS ≤8, especially head trauma, without a gag reflex
    • Induction (CCP Only)
Contraindications
Patient Factors & Considerations
  • In the vast majority of cases, a supraglottic airway device is adequate and simple troubleshooting approaches can mitigate problems (e.g. avoidance of high pressure ventilations that cause cuff leak).
  • An absolute need for endotracheal intubation is very infrequent
  • Officer managing airway is to control all patient movements.
  • Adjunct placement, ventilation efficacy and capnography waveform must be re-assessed following all patient movements.
Procedure

The most competent, current and appropriate clinician in relation to airway management should manage/coordinate the process:

  • Airway assessment (LEMON)
  • L - Look externally
    E - evaluate 3:3:2
    M - mallampati airway difficulty grade 1-4
    O - obstructions
      • Suction
      • Magill Forceps
    N - neck mobility (query spinal injury)
lemon
V2CognitiveAid2017

Disposable Catheter Mounts

  • Catheter Mounts can be used to add ‘extra length’ and flexibility to the breathing circuit when needed.
  • Catheter Mounts are connected as an intermediary between the airway adjunct and the BVM.
  • The catheter mount is made of flexible co-polymer and has a double swivel connector and flexible tubing as this provides mobility and flexibility to the patient end of the circuit.
  • The length of the tubing is around 13 cm. Be aware it increases dead space.
  • The Catheter Mount also comprises of a suction port and cap.

  • Remove from packaging, extend and connect to adjunct
  • If suctioning is required, open the cap on the suction port and directly insert flexible suction tubing to a depth no more than the length of the airway adjunct
  • When suctioning is no longer required, secure the cap over the suction port
  1. Airway - Cathmount
  2.  

  3. Airway - Cathmount2
  4.  

  5. Airway - Cathmount3
  6.  

  7. Airway - Cathmount4
  8.  

Success

Perform ventilation assessment and document checks:

  • ETT Only:
    • Visualised ETT passing through vocal cords
    • Misting of tube
  • Adequate rise and fall of chest
  • Auscultation of epigastric area first and subsequently both left and right lungs.
  • End tidal CO2 waveform and reading in mmHg
Additional Information
  • Laryngeal spasm
  • Displacement during patient movements/transfer; care should be taken, i.e. disconnect the BVM when moving patients, re-assess after moves, see notes above.

Colour assist:

Document Control


Directorate
Clinical Services

Responsible Manager
Head of Clinical Services

Published Date

Review Date

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