Post Airway Management

 

ETT, Nasal intubation, or Supraglottic Airway device

 

 

Verify tube placement through ausculation, continuous capnography and pulse oximetry

 

 

After 3 ventilations, ETCO2 should be > 10 or comparable to pre-intubation values

  • No?

 

 

  • Direct Look to confirm ETT placment

Dislodged?

  • Yes

 

 

  • Reposition ETT or remove and ventilate with BVM
  • NO

 

 

  • Secure tube
  • Remove nasal cannula if using apneic oxygenation

 

Systolic BP < 90 mm/Hg

  • Yes

 

 

OR

 

PEARLS:

  • Etiology of hypotension post intubation: Tension pneumothorax, Hyperventilation, Hypovolemia, or shock.
  • Ketamine should be used for sedation in the presence of hypotension.
  • Waveform capnography and pulse oximetry must be utilized for a minimum of 5 minutes after tube placement prior to the administration of Vecuronium (Norcuron) and is required for intubation verification and ongoing patient monitoring.
  • Bradycardia after tube placement is a strong predictor or a misplaced endotracheal tube (ETT).
  • It is required that the airway be monitored continuously through waveform capnography and pulse oximetry.
  • An Airway evaluation form must be completed on every patient who receives advanced airway management.
  • Confirm airway placement by ED staff prior to moving the patient from EMS stretcher.

NRP

National Registry Paramedic

NRP

National Registry Paramedic

NRP

National Registry Paramedic

NRP

National Registry Paramedic

NREMT

National Registry Emergency Medical Technician

NRP

National Registry Paramedic