Essentials of Airway Management, Oxygenation, and Ventilation: Part 1: Basic Equipment and Devices
Offices and outpatient dental facilities must be properly equipped with devices for airway management, oxygenation, and ventilation. Optimizing patient safety using crisis resource management (CRM) involves the entire dental office team being familiar with airway rescue equipment. Basic equipment for oxygenation, ventilation, and airway management is mandated in the majority of US dental offices per state regulations. The immediate availability of this equipment is especially important during the administration of sedation and anesthesia as well as the treatment of medical urgencies/emergencies. This article reviews basic equipment and devices essential in any dental practice whether providing local anesthesia alone or in combination with procedural sedation. Part 2 of this series will address advanced airway devices, including supraglottic airways and armamentarium for tracheal intubation and invasive airway procedures.Abstract
Oxygen regulators and cylinder content. Oxygen regulators have various designs but all have the illustrated components. Cylinders have a valve stem at their top that is turned on to release oxygen to the regulator. Cylinders vary in volume of oxygen, but their pressure is identical. A conversion factor can be used to estimate the time remaining in a cylinder at various flow rates. (See text.)
Devices for oxygen supplementation.
Bag-valve-mask with reservoir. Top left: Tubing is connected to an oxygen source with 15 L/min supplied to the device and entering the reservoir bag while the ventilation bag is compressed. When the ventilation bag is released, it expands and oxygen within the reservoir is sucked into the ventilation bag filling it with oxygen for the next compression. In some models the reservoir bag is replaced with tubing that functions similarly. Ventilation bag sizes vary from approximately 250 mL for neonates to approximately 500 mL for children and approximately 1500 mL for adults. Top right: It is recommended that bag-valve-mask (BVM) resuscitation bags are equipped with manometers that monitor ventilation pressure. Bottom left and right: One- and two-person BVM ventilations illustrate the proper mask seal using the so-called C-E technique. The mask is sealed with the thumb and first finger forming a “C” configuration over the mask, and the remaining fingers (“E”) are placed under the mandible enhancing the seal and pulling the head into a tilted position.
Basic airway adjuncts.
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