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Surgical Intern Survival Guide

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Acute airway obstruction
Attend patient and make rapid assessment
A. If patient unconscious/severe respiratory distress/respiratory arrest:
1. Tell nursing staff to call Code Blue
2. Move to head of bed
3. Perform chin lift, jaw thrust, head tilt
4. Clear mouth-suction secretions, sweep out foreign body from pharynx.

If it is an acute obstruction and the above fail, then definitive airway is required.

B. If mechanically obstructed
1. Surgical airway: cricothyroidotomy or tracheostomy

C. If acute neck haematoma
1. Open neck wound down to and including the deep fascial sutures. If still obstructed and trachea in view, attempt to incise and insert ET tube

D. If not mechanically obstructed
1. Bag and mask patient with NPA/OPA
2. This should maintain an airway until help arrives. Once more experienced provider arrives, the patient requires intubation and ET tube.
3. If unable to intubate, can try LMA.
4. If this does not secure the airway, surgical airway is necessary
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