In today’s micro-lecture, Australian Paramedical College Hon. Snr. Lecturer Sam Willis talks about the use of laryngoscope and the McGill’s forceps to clear an upper/lower airway obstruction.
Today we are going to talk about the use of laryngoscope and the McGill’s forceps to clear an upper/lower airway obstruction.
Now try and imagine this, you’re called for a patient who is reported to be choking in a restaurant. Now you know that choking situations can deteriorate rapidly. And they’re extremely stressful for anybody around them to view. Therefore, the quicker you can get there on the scene, the better. Now it’s absolutely crucial for the paramedic to have laryngoscope in their scope of practice because without it, it’s going to prove very difficult to remove any upper airway obstructions. Now managing anybody with upper airway obstruction, you have to follow the Australian Resuscitation Council’s guidelines using the backslaps.
So lean the patient forwards, five backslaps using the palm of your hands in between the shoulder blades. If that doesn’t work, five chest thrusts placing the patient in a position with your hand behind their back and the upper part of their chest at the front and doing like CPR like compressions. And they’re pretty easy to do. Now, if that’s ineffective, eventually the patient is going to lose consciousness. Then you start CPR as you would do as if they were in cardiac arrest. With the idea being that hopefully, the pressure of the CPR dislodges the upper airway obstruction.
So imagine you arrive on scene, you’re either going to see one of two things, depending on how far away you are, how far away they are, how big the obstruction is, they’re either going to still be choking and be extremely stressed and fatigued, or they’re going to be unconscious. Now let’s say you’ve arrived and they’re unconscious. This is something that you should be able to do in your scope of practice. And you’re certainly taught this in Workshop II.
So here you have a laryngoscope handle. Inside here you got batteries. Here you have the laryngoscope blades. And notice how you’ve got this little light bulb here. And it’s in this image here, you can see the light bulb. Because as you can imagine, the lower airways are quite dark. Now the lower airways begin at the opening to the trachea. But you can use this to lift and displace the tongue. The upper airways really are generally covered by the base of the tongue, but you can use it to displace the tongue to have a look for any situation.
Now you get to practice this is Workshop II, but just for now, let’s be clear that there’s this thing called a laryngoscope blade, which is this part, and a laryngoscope handle. And it lets you view the upper airway, which looks something like this. So the way that you do it is you open the patient’s airway, and you place the laryngoscope blade into what’s called the vallecular space. So this is the vallecula space here. This is the epiglottis.
And the blade goes into the vallecula space here and then you use a special type of technique, where you displace it up and to the left, which you’ll learn in Workshop II, to view the vocal cords. And here you can see the vocal cords here. And this is the opening to the trachea. You then use your McGill forceps, which is a special type of design type of forceps to actually displace the upper obstruction.
I hope you’ve enjoyed this micro-lecture on upper airway obstructions. And like I said, you will be given a chance to practice this.
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