Airway
In addition to airway adjuncts, there are a number of simple positional manoeuvres which can open the airway:
| Device | Notes |
|---|---|
| Oropharyngeal airway | • Easy to insert and use |
| • No paralysis required | |
| • Ideal for very short procedures | |
| • Most often used as a bridge to more definitive airway | |
| Laryngeal mask | • Widely used |
| • Very easy to insert | |
| • Device sits in pharynx and aligns to cover the airway | |
| • Poor control against reflux of gastric contents | |
| • Paralysis is not usually required | |
| • Commonly used for wide range of anaesthetic uses, especially in day surgery | |
| • Not suitable for high-pressure ventilation (small amount of PEEP often possible) | |
| Tracheostomy | • Reduces the work of breathing (and dead space) |
| • May be useful in slow weaning | |
| • Percutaneous tracheostomy widely used in ITU | |
| • Dries secretions, humidified air usually required | |
| Endotracheal tube | • Provides optimal control of the airway once the cuff inflated |
| • May be used for long or short-term ventilation | |
| • Errors in insertion may result in oesophageal intubation |
◦ accounts for around 5% of major airway complications
◦ therefore monitor end-tidal CO2 (capnography)
• Paralysis often required • Higher ventilation pressures can be used |