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Upper airway obstruction :lollipop: (:male-scientist::skin-tone-4:Inx (CXR…
Upper airway obstruction
:lollipop:
Def
Upper airway: Nose ⇨ Trachea
UAWO = ภาวะที่ลมหายใจผ่านเข้าปอดไม่ได้ or ไม่สะดวกจากการตีบตัน URT
PathoPSO
UAWO ⇨ Alveolar hypoventilation
Asphyxia
Acute/Chronic
:fog:
Hx
:rainbow:
PE
ENT examination
Lungs
:star:
Stridor
: inspiratory, expiratory, biphasic
Retraction: Supraclavicular, Suprasternal, Intercostal, Subcostal
Cyanosis
Further
Fiberoptic bronchoscope
Rigid bronchoscope
:male-scientist::skin-tone-4:
Inx
CXR
Inspire
Expire
Lateral decubitus
Film lateral neck (soft tissue technique) look for FB, abscess
Film skull series (trauma)
Fluroscopy (Thai not use)
Blood gas (if got hypoxemia/acidosis)
Spirometry (if u think lung involved too)
Etiology
Newborn
:baby::skin-tone-3: - Congenital ds
Children
:boy::skin-tone-4: - Infection, FB, Trauma
Adult
:man::skin-tone-4: - Tumor, Trauma
:green_apple:
Treatment
Site of obstruction?
Condition of pt, Trauma assessment?
Appropriate, gently, less traumatic bypass Upper airway
:green_apple:
Mx
Conservative Rx
Humidified O2
Helium : O2 (80:20)
Racemic epinephrine for Croup
Corticosteroid
ATB
Control Airway
Endo
luminal procedure
Nasopharyngeal AW
Oral AW
Transoral intubation (
ETT
)
:check:
I/C
On ventilator
UAWO
Pulmonary toilet
Aspiration
:red_cross:
C/I or !
C-spine injury
Laryngeal injury
Severe oral cavity injury/Trismus
Nasal intubation (Nasotracheal tube)
Trans
luminal procedure
Transtracheal needle ventilation
:star:Cricothyroidotomy
*For Emer so u ต้องทำได้
Tracheostomy