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Learning about Artificial Airways for Nursing Students
I commonly see artificial airways in PACU as a nurse in a trauma hospital and have learned that they can be tricky, but also very beneficial to the patient.
Sometimes a patient will come out of the OR with a new tracheostomy and I spend a lot of time suctioning for them. This is not limited to the trach itself but also orally as secretions are abundant for these patients at first.
Having a whiteboard or clipboard with paper and pen nearby helps the patient communicate better and teaching simple requests by hand is helpful too! I will tell them “Hold one finger up for mouth suction, hold two up if you feel that you need trach suction”.
This has been a game changer for me in providing them with the best care possible as they adjust to their new airway.
The Purpose of Artificial Airways:
a. Protect the airway when the client can’t b. Provide a route for mechanical ventilation
Nursing Assessment for Artificial Airways
1. Assess Airway 2. Assess Breathing 3. Assess Level of Consciousness 4. Choose correct airway 5. Call for help for advanced airway
Therapeutic Management for Artificial Airways
1. Nasopharyngeal Airway a. AKA “Nasal Trumpet” b. Client’s can’t clear secretions c. Breathing independently d. Conscious 2. Oropharyngeal Airway a. AKA “Oral Airway” b. Client can’t protect airway c. Unconscious 3. Endotracheal Tube a. AKA “ET Tube” / “intubation” b. Client can’t protect airway c. Not breathing or requires ventilation d. May be conscious or unconscious before intubation 4. Tracheostomy Tube a. AKA “Trach” b. Client has to be “weaned” (discontinued) from the ventilator slowly c. Long term requirement for the following: d. Neuromuscular e. Tracheal damage
Nursing Case Study for Artificial Airways
An 18 year old female is brought into the emergency department after a bicycle accident. The report from EMS is that witnesses observed the patient hit her throat area on the handlebars when she lost control of her bike.
She is currently unconscious and EMS has placed an OPA while using a bag valve mask to oxygenate. She is currently displaying an O2 sat of 89% and the laryngeal area of the neck appears to be notably swelling. EMS reports she had O2 saturation of 94% en route.
What type of airway will you administer next and what teams will you contact for intervention?
Type of Airway Intervention: Given the patient's unconsciousness, swelling, and need for improved oxygenation, endotracheal intubation would likely be the appropriate next step. This involves inserting a tube into the trachea to ensure a clear airway and facilitate controlled ventilation.
*NCLEX tip: think ABC’s. If the throat has trauma what will be the best intervention moving forward to maintain the airway of an unconscious patient with trauma?
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