Nâng cằm cơ động có thể được thực hiện bằng cách đặt hai ngón tay dưới hàm dưới và nhẹ nhàng nâng lên trên để mang lại trước cằm. Trong cơ động này cổ không nên được mở rộng siêu. | Primary Trauma Care Appendix 1 - Airway Management Techniques Basic techniques Chin lift and jaw thrust The chin lift manoeuvre can be performed by placing two fingers under the mandible and gently lifting upward to bring the chin anterior. During this manoeuvre the neck should not be hyper extended. Demonstrated in the Practical session The jaw thrust is performed by manually elevating the angles of the mandible to obtain the same effect. Demonstrated in the Practical session Remember these are not definitive procedures and obstruction may occur at any time. Oropharyngeal airway The oral airway must be inserted into the mouth behind the tongue and is usually inserted upside down until the palate is encountered and is then rotated 180 degrees. Care should be taken in children because of the possibility of soft tissue damage. Nasopharyngeal airway This is inserted via a nostril well lubricated and passed into the posterior oropharynx. It is well tolerated. Advanced techniques Orotracheal intubation If uncontrolled this procedure may produce cervical hyper-extension. It is essential to maintain in line immobilisation by an assistant . Demonstrated in the Practical session Cricoid pressure may be necessary if a full stomach is suspected. The cuff must be inflated and correct placement of the tube checked by verifying normal bilateral breath sounds. Tracheal intubation must be considered when there is a need to establish a patent airway and prevent aspiration deliver oxygen while not being able to use mask and airway provide ventilation and prevent hypercarbia. This should be performed in no more than 30 seconds if unable to intubate then ventilation of the patient must continue. Remember patients die from lack of oxygen not lack of an endo-tracheal tube. Remember patients with trauma of the face and neck are at risk for airway obstruction Primary Trauma Care Surgical cricothyroidotomy This is indicated in any patient where intubation has been attempted and failed and
