Managing Ventilation Through a Surgical Airway: Essential Steps

Introduction

When dealing with patients who have a surgical airway in their neck, proper ventilation techniques are crucial for their care and safety.

Positioning

Ensure the patient's head is in a neutral position, with the shoulders slightly raised using a coat or blanket to support them.

Ventilation Techniques

• Using Bag Valve Mask (BVM) or Pocket Mask: Ventilate through the stoma using a child or infant-sized mask for better sealing around the neck.
• Sealing Mouth and Nose: Seal the patient's mouth and nose with your hand or a pocket mask without a valve during ventilation. Release during exhalation to allow air to escape.
• Two-Person Technique (BVM): If using a BVM, enlist the help of another person—one to apply the mask and seal the mouth, and the other to squeeze the BVM.
• Monitoring with Stethoscope: If trained, listen to the chest with a stethoscope to ensure proper air entry into the lungs.

Obstruction Management

If ventilation is hindered, consider using a soft tip suction tube in the stoma. If unsuccessful, attempt ventilation through the mouth and nose to clear the obstruction.

Oxygen Supply

If oxygen is available, connect the BVM or pocket mask to a 15 litres per minute oxygen supply for enhanced ventilation.