Summary

In session IV you have learnt

• Loss of upper airway muscle tone in anesthetized patients allows the tongue and epiglottis to fall back against the posterior wall of the pharynx.
• The simplest way of ensuring an open airway in an unconscious patient is a head tilt and jaw thrust maneuver, they can lift tongue from the back of the throat. Head tilt maneuver is contraindicated in the presence of possible cervical injury. The jaw thrust without head tilt is the technique of choice for a patient with a suspected neck injury since it causes the least amount of movement in the cervical spine.
• Oropharyngeal or nasopharyngeal airways help to maintain a clear airway by displacing the tongue and other tissue from the posterior portion of the hypopharynx.
• The correct size can be estimated by holding the airway next to the patient's mouth. A typical adult female will take an 8-cm oral air way, and an adult male, 9 or 10 cm. If the airway repeatedly comes out of the mouth, it should be removed and a smaller size tried.
• A nasal airway can be used in a patient who has difficulty opening their mouth. It should be lubricated and gently inserted. Do not place a nasopharyngeal airway in patients with facial or nasal fractures, anticoagulated patient and hypertrophied tonsil.
• The use of a face mask can facilitate delivery of oxygen or of an anesthetic gas from a breathing system to a patient by creating an airtight seal with the patient's face.
• Failure to place an endotracheal tube is not the actual cause of the severe adverse outcomes related to difficult airway management. The primary problem is an inability to oxygenate, ventilate, prevent aspiration, or a combination of these factors.
• The bag-valve mask ventilation device is used to manually deliver positive pressure through an applied face mask, extra-glottic device or endotracheal tube. These devices incorporate a self-inflating bag, a one-way bag inlet valve, and a nonrebreathing patient valve.
• Laryngeal mask airway is an alternative to mask ventilation during a general anesthetic. The laryngeal mask airway does not protect against the aspiration of gastric contents.