The management of airways involves the planning, assessment, and various medical protocols that ensure maintenance and restoration of the ventilation of a given individual. When the airways are maintained, the available air flows from the mouth and the nose to the lungs. Management of airways is considered a significant skill for all the healthcare givers who are faced with critical situations within their profession. It is a vital practice in medical studies. When there is no airway management wherever it is required, an individual may have lower levels of oxygen, which is a threat to people’s lives. Healthcare givers use different kinds of artificial airways to ensure good health within the population. Some of the significant examples are the oropharyngeal airway (OPA), endotracheal airway (ETA), and the Nasopharyngeal (NPA). The paper examines airway management as an effective practice that enhances airflow within the human body.
Using Appropriate Evidence Define Best Practice In Terms Of Airway Management
Management of airways is in two distinct categories, which are the advanced and the basic categories. The basic techniques are always non-invasive. They do not require any specialized kind of equipment or advanced sessions of training. A good example is the maneuvers from the head to the patient’s neck to optimize the back blows, ventilation, and abdominal thrusts. Advanced techniques, on the other hand, require very specialized medical pieces of equipment and training (Shrimanker et al., 2017, p.1028). They are the supraglottic types of equipment like the nasopharyngeal and oropharyngeal airways. There are also supraglottic approaches like tracheal incubations and surgical techniques like tracheotomy and cricothyrotomy. Management of the airways is among the primary considerations within cardiopulmonary resuscitation, emergency medications, and the first aid options when a person is injured.
The ability to participate and recognize all the forms of decomposition of respiratory systems is a pillar and significant step in managing airways. Most practitioners require some familiarity with the techniques and indicators of interventions of airways and the procedures of anticipating a critical airway. The primary approach involves assuring protection and patency of airways from aspirations and provision of adequate ventilation and oxygenation (Yao et al., 2020, p.1314). That is why healthcare givers should strive to incorporate the best airway management assessment strategies as the best practice in airways management. Sometimes nurses are faced with various failed attempts of incubation on different patients, and management of a difficult airway is among the challenging experiences of a healthcare giver. Gradually, nurses always realize that when they have greater anticipation of a particular medical issue, they tend to prepare for the same, making them avoid any potential crisis.
One of the strategies to manage a challenging airway is evaluating the airway. The assessment is like a physical examination or medical history of a patient. A healthcare giver should take their time to assess the patient’s chart and determine whether there are many indicators of previous difficulties of the airways (Filippelli et al., 2021, p.130). They may also identify any medical conditions that predispose a challenging airway. Additionally, healthcare givers could take their time to assess the physical features of a patient and all the other character traits like a short and thick neck, a narrow plate, limited motion from the head to the neck, and all the long upper indicators which are regarded as non-reassuring findings that make incubation a more significant challenge.
Another approach is ensuring that the specialized airway pieces of equipment are easily accessible and available at all times. Having a portable cart with various equipment for managing difficult airways is essential. Some of the pieces of equipment are a flexible fiberscope bronchoscope, surgical airway pieces of equipment, and video laryngoscopes. Also, healthcare givers can administer oxygen to different patients with airway difficulties at varying intervals during the management process (Gibson and McDonald, 2017, p.624). The available guidelines indicate that patients with difficult airways can always get pre-oxygenated using a facemask before any attempts of incubation are made. It equally recommends that the patient receives administered oxygen as many times as possible throughout airway management. Such may be through a nasal cannula, laryngeal masks, or a face mask.
Explain, And Justify, The Various Indications, Contraindication And Method Of Intubation Within The Pre-Hospital Setting
The indications for intubation for securing an airway involve respiratory failures, reduced consciousness, apnea, injuries in the airway, rapid change in the status of the mind, compromises on the airways, more significant aspiration risks, and any form of trauma such as penetration of injuries in the chest, abdomen or the neck (Fingleton et al., 2018, p.25). The contra indicators to the endotracheal intubation are various forms of airway trauma or obstructions that never permit safer placement of endotracheal tubes. When the endotracheal boxes cannot be placed yet, the airways need to be secured a surgical airway is always indicated. Among adults, a cricothyrotomy or needle cricothyrotomy is always considered an emergent option. For pediatric patients who cannot have an endotracheal tube, a cricothyrotomy is rarely performed because most healthcare givers prefer tracheostomy. Healthcare givers are always critical about the age of the patient to ensure a safer cricothyrotomy.
The pieces of equipment used in this case seek to ensure proper airway positioning and clearance. The upper airways obstruction is always relieved via head tilts, haw thrust, or a chin lift. Among children, a simple suction of the airway helps ensure clearance. Bulb syringes and other mechanical suction devices allow clearing mucus and other forms of debris within the airways. When bulb syringes are used to suction infants, it is essential to ensure the mouth is suctioned before the nose to avoid different forms of aspiration. Nurses always depress the bulb syringes and later place them in the patient’s mouth and nose (Shrimanker et al., 2017, p.1029). Infants are also prone to different forms of vagal stimulation that may result in bradycardia. That is why any suction should never last for more than 10 seconds.
The equipment should also ensure adjuvants to any form of obstructions of the upper airways. One cannot use the oropharyngeal airway among patients with a severe gag reflex or those experiencing oral trauma. Such an approach could stimulate the gag reflex and generate aspiration of various gastric contents (Filippelli et al., 2021. p.131). oral appliances always have a different size. They are measured and sized from lips to angles the jaw. Therefore, they are helpful for patients who have spontaneous respirations and those who need assistance in the opening of their airways.
Another practical approach is the big mask ventilation technique which is essential for managing airways for both children and adults. One may relieve the obstructions in the upper airways, which are always encountered in simple mask ventilation through tilting the head, thrust of the jaws, and applying continuous positive pressure on the airways (Schieren et al., 2018, p.1259). The approach is also considered effective in preparations to intubate. The advanced airway approach is also practical where laryngeal mask airways, esophageal-tracheal tubes, and laryngeal tubes are always used to ensure a secure and stable airway. The approach is highly effective in emergent settings where all the emergency healthcare givers and other technicians seek to establish a pediatric airway. They may not be very confident about the decision.
Critique The College of Paramedic’s Position Statement on Intubation and the Literature Review That It Draws Its Findings From
The consensus statement offers specific guidelines to the profession—all the guidelines related to tracheal intubation applicable in paramedics. The statement does not eliminate skills of tracheal intubation from different paramedics around the world. It does not seek to debate about the efficiencies of intubation or the long-term effects of intubation on morbidity and mortality as the formal studies respond to such queries. The authors focus on tracheal intubation, a vital skill for every paramedic since the eighties (College of Paramedics, 2020, p.3). The skills are always taught to different healthcare givers and other pre-registration programs of paramedic training. It is an essential topic because paramedics work in diverse clinical environments like acute care environments, urgent and primary care, military and private sectors, and ambulatory services, which offer them an excellent opportunity to practice tracheal incubation.
The consensus report is detailed as it gives definitions to terms such as incubation attempts which involve the insertion of laryngoscopes to airway cavities to gain a good view of the laryngeal inlets. Another term is successful intubation, where the passage of tracheal tubes via the vocal cords gets into the trachea with confirmations of tube placements via clinical assessments and monitoring of different objectives (College of Paramedics, 2020, p.4). There is a failed laryngoscopy where healthcare givers fail to achieve a good view of the laryngeal inlets. A failed intubation is the failure to perform a good idea of the trachea and simulation, which involves all the techniques seeking to replicate the substantial aspects of the natural world in a highly interactive manner.
The article is well-grounded because various pieces of evidence were reviewed to assist in report development. Multiple studies attribute the more excellent morbidity rates to out-of-hospital profound effects. Healthcare givers incorporated airway management as a fundamental routine in the paramedics to minimize the total number of deaths. The consensus group made observations such as the significance of maintaining intubation skills by ensuring proper determination of the approaches used by paramedics to study intubation (College of Paramedics, 2020, p.5). Another evidence is the exact number of intubations required to achieve a faster intubation rate of success. The approaches are different depending on environmental conditions. Also, there is training and education of tracheal incubations that involve various modalities like videos, lectures, simulation, and practical skills. The non-technical skills are also significant and worthy of inclusion in the syllabus.
The report gives the training and education standards for patients. The team members propose that laryngoscopy should remain a fundamental skill in pre-registration of all paramedic training programs. It is also detailed as it gives the requirements of pre-registration training requirements and inclusion of the other skills which are not very technical. For the post-registration training approaches, all paramedics should make efforts to undertake intubation. The measures involve comprehensive training in all the failed intubation skills while considering the use of various tools that seek to enhance laryngoscopy (College of Paramedics, 2020, p.6). The report further assesses the critical competencies by giving a variation of various evidence related to the development of competence for the undertaking of intubation.
The traditional paramedic training is a standard benchmark for 25 supervised intubations within a controlled ecosystem. Such supervisions are critical in the development of the necessary skills of competence. The report gives the defined standards of good equipment. All equipment used must meet the mandatory minimum requirements that have to be applied regularly by every paramedic who performs tracheal intubation (College of Paramedics, 2020, p.7). Additionally, it suggests various clinical governance approaches that organizations have to incorporate to ensure the existence of multiple systems of governance, such as the names of all clinicians who have the obligation of practicing intubation via paramedics. There should also be a well-defined clinical governance framework and policies that outline the systems that are in place to ensure constant monitoring of the safety and quality of the types of equipment.
Using An Appropriate Model, Write A Short Reflection On Your Experience Of Airway Management
One of the standard practices in an ICU is tracheal incubation which is common among patients suffering from failures of their respiratory organs. It involves various skills and techniques that call for intensive training, expertise, and practice. Excellence in the management of airways is vital because when it’s not there, it compromises the quality of healthcare services offered to the patients and also affects their safety (Filippelli et al., 2021, p.132). As a nurse in the ICU, I have handled various patients who are critically ill and experience challenges with the management of their airways. One of the approaches to delivering quality care among such patients is ensuring an effective response to preoxygenation. Pre-oxygenation may be done optimally by providing the PEOs of more excellent than 90%, extending to apnea safety time margins for all the critical patients in the ICU.
There are times when the standard pre-oxygenation techniques used in both optimized and surgical patients fail to sustain adequate PaO2 (Dabija et al., 2019, p.152). Such is common among patients who have a hyper profile of metabolism within the apneic incubation period. I once encountered a patient who had hypoxia that was rapidly deteriorating the management of her airways. The patient faced the threat of cardiopulmonary failure, which is not so uncommon in ICU. I was fortunate because I have some airway management expertise, which helped save the patient’s life. There were various attempts of multiple incubation and esophageal intubations. The consequences were equally adverse because of the greater probability of brain damage and cardiac arrest among patients. My experience and expertise in airway management prevented the patient from contracting edema.
Another significant skill is the ability to assess and evaluate different airways. Evaluation of tracheal incubations is a very standard requirement in the provision of anesthesia care. Therefore, it should be practiced consistently within ICUs before any tracheal intubation (Sakles et al., 2017, p.168). I have experience conducting a detailed airway test, which makes it easier to save the lives of most patients. A good approach involves the classification of mallampati, mobility of the neck, body mass index, and inter-incisor distances which are highly effective predictors for a difficult airway.
Discuss How In The Future You Are Going To Ensure That You Will Meet Each Of The HCPC Standards For CPD
Ensuring that I meet all the CPD standards requires conducting a regular CPD and keeping records of everything that is done and what is highly convenient for a given organization and an individual. It also involves regularly carrying out various learning activities and thinking of how a particular CPD may improve healthcare practice and benefit other users of the same services (Hewlett et al., 2017, p.3399). Also, it is essential to participate in different audits because there is the auditing of random samples of every profession whenever there is a renewal. Audited caregivers have to renew their registration regularly through completing the professional declarations and paying fees for registration.
How Will You Maintain an Up To Date Accurate Record of Your CPD Activities
One of the approaches to maintaining an adequate CPD record is ensuring standardization of meetings. All the sessions of standardization contribute significantly towards a CPD. The other approach is ensuring that one attends the CPD events and conferences held at intervals in the UK. The events have expert speakers who address various aspects that guide healthcare givers on the new unfolding and the best approaches to a practical way forward. Another method is ensuring feedback, reflection, evaluation, and action approach. Feedback allows one to identify their thoughts with strengths and weaknesses and thus ensures that individuals get helpful feedback because many individuals learn from constructive criticism (Hewlett et al., 2017, p.3400). Reflection allows one to think about what they have learned and whatever changes they can implement to overcome their current weaknesses.
On the other hand, evaluation involves compiling some of the ideas and what can be done to ensure different changes. Action, on the other hand, ensures something is done to address the existing gaps. It is essential to constantly review steps and ensure that something productive is done regarding the CPD activities.
What CPD Activities Could You Undertake To Fulfil The HCPC Requirements?
Some of the CPD activities are learning through actions, case studies, and reflective practices. Individuals may also engage in audits, coaching, work shadowing, and peer reviews to ensure they meet all the HCPC requirements.
How Would These CPD Activities Contribute To The Quality Of Your Practice And Service Delivery?
CPD ensures that healthcare givers make significant contributions to their teams during their practice. It ensures that individuals are productive at work and assist in developing careers as different individuals grow in the profession (Hewlett et al., 2017, p.3401). CPD allows one to be an effective leader; it will enable management, mentorship, and coaching of other team members to become influential professionals.
How Would These CPD Activities Benefit the Service User?
The activities will benefit users by ensuring that they maintain and enhance skills and knowledge for delivery in professional services (Sakles et al., 2017, p.169). It also allows individuals to remain updated with the ever-changing trends as they become more effective in their profession. Also, it ensures everyone remains interested in their career with a greater understanding of the implications of their jobs.
In conclusion, the management of airways is vital among individuals in different circumstances. The circumstances range from choking to complicated airway obstructions. The obstructions always occur because of the tongue and other foreign substances that block airways. Therefore, healthcare givers must develop the necessary expertise to minimize the total deaths resulting from poor air management techniques.
College of Paramedics (2020) Incubation Consensus Reports https://collegeofparamedics.co.uk/COP/Professional_development/Intubation_Consensus_Statement_/COP/ProfessionalDevelopment/Intubation_Consensus_Statement_.aspx?hkey=5c999b6b-274b-42d3-8dbc-65
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