Course Content
BACKGROUND
Introduction Approximately 360 000 adults suffer an emergency medical service (treated out of hospital cardiac arrest in the United States each year. Cardiac arrest continues to be a devastating condition for most individuals with a current overall survival rate of around 10%. Outcomes have improved since the introduction of the cardiac arrest chain of survival in the early 1990 s however, there are still many areas of resuscitation science to be explored, which could potentially improve patient outcomes.One of the most important links in the chain is early high quality cardiopulmonary resuscitation (with an emphasis on chest compressions. However, guidelines provide rescuers with minimal direction on optimal ventilation management during resuscitation.- Ventilation may play a crucial role in cardiac arrest resuscitation by allowing for adequate oxygen administration and meaningful carbon dioxide elimination, thereby improving cellular metabolism. - Modifiable factors affecting out of hospital ventilation include rate, tidal volume, ventilation delivery time, airway pressure, and timing with chest compressions. - The goals of this narrative review are to evaluate the available evidence regarding the role of ventilation in out of hospital cardiac arrest resuscitation and to provide recommendations for future directions.
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INTRODUCTION
AIRWAY MANAGEMENT AIRWAY MANAGEMENT IN PREHOSPITAL SETTING
24:53
CHALLENGES
ANATOMY RESPIRATORY SYSTEM
10:53
AIRWAY MANAGEMENT – LT KING AIRWAY
REFERENCES
EMS Training: Airway Management – LT King Airway

    ANATOMY RESPIRATORY SYSTEM

    Larynx
    The larynx is a cartilaginous structure inferior to the laryngopharynx that connects the pharynx to the trachea and helps regulate the volume of air that enters and leaves the lungs Figure 22 7

    The structure of the larynx is formed by several pieces of cartilage
    Three large cartilage pieces the thyroid cartilage ( epiglottis
    (and cricoid cartilage ( form the major structure of the
    larynx

    The thyroid cartilage is the largest piece of cartilage that makes up the larynx The thyroid cartilage consists of the laryngeal prominence or “Adam’s apple,” which tends to be more prominent in males.

    The thick cricoid cartilage forms a ring, with a wide posterior region and a thinner anterior region.

    Three smaller, paired cartilages the arytenoids, corniculates, and cuneiforms, attach to the epiglottis and the vocal cords and muscle that help move the vocal cords to produce speech.

    The epiglottis attached to the thyroid cartilage, is a very flexible piece of elastic cartilage that covers the opening of the trachea (see Figure 22 4 When in the “ position, the unattached end of the epiglottis rests on the glottis

    The glottis is composed of the vestibular folds, the true vocal cords, and the space between these folds Figure 22 8

    A vestibular fold or false vocal cord, is one of a pair of folded sections of mucous membrane
    A true vocal cord is one of the white, membranous folds attached by muscle to the thyroid and arytenoid cartilages of the larynx on their outer edges.

    The inner edges of the true vocal cords are free, allowing oscillation to produce sound The size of the membranous folds of the true vocal cords differs between individuals, producing voices with different pitch ranges

    Folds in males tend to be larger than those in females, which creates a deeper voice.
    The act of swallowing causes the pharynx and larynx to lift upward, allowing the pharynx to expand and the epiglottis of the larynx to swing downward, closing the opening to the trachea.These movements produce a larger area for food to pass through, while preventing food and beverages from entering the trachea.

     

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