Airway patency

Forced vital capacity (FVC) quantifies the maximum air volume expired following a maximal inspiration and is one of the basic measures of analyzing flow changes such as reduced airway patency observed in asthma. To measure FVC, an individual inhales maximally and then exhales as rapidly and completely as possible. FVC primarily reflects the elastic properties of the respiratory tract. The gas volume forcibly expired within a given time interval, FEV (where t is typically one second, FEVj q)... 

Drugs Used to Maintain Airway Patency in Obstructive Pulmonary Disease... 

Individuals with OSA usually have structural narrowing of the upper airway but are able to maintain upper airway patency in wakefulness, albeit with increased levels of genioglossus muscle (the major pharyngeal dilator) activity compared to... 

Assess and maintain airway patency assess for foreign bodies and fracfures fhaf may lead to obstruction. 

Facial and neck injuries may predispose the victim to airway and ventilatory difficulty. Airway compromise may result if the patient with facial fractures remains in a supine position due to lack of bony support. Progressive airway obstruction may also result from hemorrhage from penetrating neck wounds. Bleeding into the trachea, bronchus, and lungs will all compromise the victim s airway and ventilatory status. An artificial airway should be placed to maintain airway patency until intubation is required (American College of Sur-... 

Usually intravenous pre-oxygenation followed by a small dose of an opioid, e.g., fentanyl or alfentanil to provide analgesia and sedation, followed by propofol or, less commonly, thiopental or etomidate to induce anaesthesia. Airway patency is maintained with an oral airway and face-mask, a laryngeal mask airway (LMA), or a tracheal tube. Insertion of a tracheal tube usually requires paralysis with a neuromuscular blocker and is undertaken if there is a risk of pulmonary aspiration from regurgitated gastric contents or from blood. 

Treatment options are largely supportive. An assessment should first be made for airway patency and adequacy of breathing. Circulation may become affected as shock develops secondary to severe gastroenteritis. The following laboratory studies are recommended for all symptomatic patients computerized blood count, electrolytes, and coagulation studies (prothrobin time, activated partial thromboplastin time). In cases of uncertain or unknown exposure, there is an enzyme-linked immunosorption assay test available for the detection and verification of the presence of ricin... 

Epinephrine (adrenalin) Epinephrine is a nonselective sympathomimetic given subcutaneously, IV, or via an endotracheal tube in emergency to restore circulation and increase airway patency. 

Preexisting airway damage (such as that caused by prior toxic inhalant exposure) may seriously compromise the respiratory system s normal protection and clearance mechanisms. Specifically, there may be depletion of critical enzyme systems. Cigarette smoking may severely compromise airway function with respect to both airway patency and clearance mechanisms. Hyperreactive airways (asthma in varying degrees) are seen in up to 15% of the adult population. Toxic inhalant exposures... 

Adequate control of the airway is important in all toxic inhalant exposures. Exposure to centrally absorbed toxic inhalants (such as chlorine) and to fires may be particularly dangerous, insofar as laryngeal or glottal edema may rapidly compromise upper airway patency. Evidence of perinasal or perioral inflammation indicates the need for more careful investigation of the oropharynx for erythema. Subsequent laryngoscopy or bronchoscopy may be of particular value and should be undertaken along with preparations for expedient intubation. The presence of stridor indicates the need for immediate airway control. 

Riser N. The hitch-hikers guide to nasal airway patency. Respir Med 1990 84 179-183. 

Dasgupta and colleagues (1998) treated 20 patients with neoplastic tracheobronchial strictures with uncovered Wallstents. Stents were successfully deployed in all patients and airway patency was restored. Four patients were successfully weaned after stent insertion, five were receiving mechanical ventilatory assistance, while the remaining died from unrelated causes while receiving mechanical ventilatory assistance. No deaths occurred from stent failure or stent related complications. 

One of the most unresponsive comphcations of RA is BO. The pathology of this disorder involves circumferential narrowing and obliteration of small airways with loss of airway patency that is usually permanent. Symptomatic progression can be indolent however, most of the airways that are lost cannot be recovered with anti-inflammatory therapy. 

Ventilatory support can be provided with NIPPV from volume-cycled ventilators via an angled mouthpiece, lipseal, nasal, or oral-nasal interface. Simple 15- or 22-mm-angled mouthpieces are most convenient for daytime ventilatory support (Fig. 3). To use mouthpiece IPPV, adequate neck rotation and oral motor function are necessary to prevent leakage from the mouth or nose. In addition, the patient must open the glottis and vocal cords, dilate the hypopharynx, and maintain airway patency to receive the air. 

Patients who benefit from MAC have weak respiratory muscles but adequate bulbar-innervated muscle function for airway patency, although insufficient for air stacking to... 

Assessing each victim for responsiveness, airway patency (blockage), breathing, circulation, and medical alert tags ... 

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