The patient may have liquid (gastric contents, saliva, blood) present in the upper airway. This has the potential to cause airway obstruction or aspiration and therefore needs to be removed from the upper airway as quickly as possible.
There are a variety of suction devices available to assist in clearing the upper airway. The commonest device is a wide-bore rigid sucker (Yankauer), which is attached to a suction apparatus. Important points to remember are:
• the rescuer should always wear gloves when suctioning the patient;
• to perform oropharyngeal suctioning, the suction device should be carefully inserted into the patient's mouth. The tip of the suction device should be visible at all times to avoid stimulating a gag reflex.
Figure 7.1 illustrates a Yankauer sucker and suction unit. AIRWAY ADJUNCTS
Airway adjuncts help improve and maintain an open and patent airway. Commonly used adjuncts include the oropharyngeal airway and nasopharyngeal airway. Both of these adjuncts can be used in the patient who is unconscious and has stopped breathing. In this situation the adjuncts help maintain airway patency during the use of ventilatory devices such as the pocket mask or bag-valve-mask system (AHA & ILCOR 2000). The unconscious patient who has stopped breathing may also benefit from the insertion of a device such as an LMA or Com-bitube, both of which offer a slightly more secure airway when personnel skilled in endotracheal intubation are not immediately available (Stone et al. 1998).
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