Page 40 - ATP-P 11th Ed

Table 3 PCC Role-based Guidelines for Airway Management
PCC Role-based Guidelines for Airway Management
SECTION 1 T T T T *All Personnel - Complete Basic TCCC Management Plan for Airway then:
C
C
C C Assess for airway problem; use patient positioning per TCCC guidelines to maintain open
C
C C airway.
C
C
- C - C - C -
A C C C
S L M P
M S C P
• Re-assess airway interventions performed in TCCC.
• Positive end-expiratory pressure (PEEP) valves should be used anytime you are using a
bag valve mask.
• Use nasal pharyngeal airway (NPA).
• Ensure all interventions noted above are completed by TCCC ASM and CLS personnel.
• Conduct inventory of all resources.
• Document all pertinent information on PCC Flowsheet (attached).
• Additional interventions include:
Role 1a
• Airway adjuncts should be assessed for efficacy by checking the patient’s work of breath-
ing, end-tidal CO (EtCO ) and pulse oximetry levels.
2
2
• Level of sedation should be continuously assessed every 5 minutes for patients sedated
deep enough for endotracheal intubation.
Role 1b
• Re-asses airway before, after and during any patient movement.
• Airway adjuncts with an inflatable cuff such as ET or cricothyrotomy tube or inflatable
laryngeal mask airways (LMA) should be assessed for proper inflation levels to ensure that
they are not under or over inflated.
• Inflate the cuff with a 10mL syringe and then releasing your thumb from the plunger to let
the plunger equalize.
Role 1c
• Airway adjuncts with an inflatable cuff such as ET or cricothyrotomy tube or inflatable
LMA should be assessed for proper inflation levels to ensure that they are not under or
over inflated.
• Mechanical suction device and yankauer suction for suctioning out the oropharynx.
• Airway adjuncts should be assessed for efficacy by checking the patient’s work of breath-
ing, EtCO and pulse oximetry levels.
2
• Mouth care should be performed per the attached nursing care checklist in appendix.
• Ensure above interventions are completed by TCCC ASM, CLS and CMC personnel.
• Conduct inventory of all resources.
• Document all pertinent information on PCC Flowsheet (attached).
• Additional interventions include:
Role 1a
• Re-assess all prior MARCH interventions.
Role 1b
• Re-assess cuff pressures per above.
• Continued assessment of patient’s work of breathing, EtCO and pulse oximetry levels.
2
Role 1c
• Inflate and periodically check cuff pressures with a cuff manometer to a goal of 20mmHg.
• Use heat moisture exchanger to keep contaminants out and endogenous heat and moisture
in the lungs.
• Inline suction catheter for suctioning airway adjunct as indicated.
Airway Management in Prolonged Field Care, 01 May 2020 9
https://jts.health.mil/assets/docs/cpgs/Airway_Management_in_Prolonged_Field_Care_01_May_2020_ID80.pdf
30 SECTION 1 TACTICAL TRAUMA PROTOCOLS (TTPs) ATP-P Handbook 11th Edition 31