airway

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airway

 [ar´wa]
1. the passage by which air enters and leaves the lungs.
2. a mechanical device used for securing unobstructed respiration when the patient is not breathing or is otherwise unable to maintain a clear passage, such as during general anesthesia or respiratory arrest.
Oropharyngeal Airway. This device is inserted into the mouth to prevent the tongue from obstructing the pharynx.
Esophageal airway.
It should not be used on alert or semiconscious patients, as it invariably stimulates the gag reflex and causes vomiting or injury to the jaw unless the patient is deeply unconscious.

Selection of proper size is essential because an airway that is too short cannot lift the tongue away from the oropharynx. The airway should be gently inserted so as to avoid trauma to the mucous membranes. It must be inserted with the tip up and rotated 180 degrees when it reaches the back of the throat so that the tongue is not displaced back into the pharynx, where it will obstruct the air passage. The proper size is the distance from the earlobe to the edge of the mouth.
Esophageal Obturator Airway. This is a hollow tube inserted into the esophagus to maintain airway patency in unconscious persons and to permit positive-pressure ventilation through the face mask connected to the tube. It was designed to be used by trained pre-hospital medical personnel to establish an airway. Its use has declined because of training of pre-hospital medical personnel in the insertion of endotracheal tubes, and because studies have suggested poor performance.
Esophageal Gastric Tube Airway. This is a hollow tube with a balloon at the end, which is blindly inserted into the esophagus, obstructing the esophagus and theoretically forcing air into the trachea, thus decompressing the stomach and alleviating abdominal distention; it represents an improvement in the design of the esophageal obturator airway. Ventilation occurs in the oropharynx.
Nasopharyngeal Airway. This is a hollow tube placed through the nose into the nasopharynx to bypass upper airway obstruction or to decrease trauma from nasotracheal suctioning.
Endotracheal Tube (or Airway). This inflatable tube is inserted into the mouth or nose and passed into the trachea to provide mechanical ventilation, to provide a suction route, to prevent aspiration of stomach contents, and to bypass upper airway obstruction.
Tracheostomy. This involves a surgical incision into the trachea and insertion of a metal or plastic tube through the incision. (See also tracheostomy.)
airway clearance, ineffective a nursing diagnosis accepted by the North American Nursing Diagnosis Association, defined as inability by an individual to clear secretions or obstructions from the respiratory tract to maintain a clear airway. Etiologic factors include decreased energy and fatigue; infection, obstruction, or excessive secretions in the tracheobronchial tree; perceptual/cognitive impairment associated with decreased oxygenation to brain cells; and trauma to the respiratory tract.

Defining characteristics presented by a person with ineffective airway clearance are likely to include abnormal breath sounds, alterations in respiratory rate or depth, cough (effective or ineffective and with or without sputum), cyanosis, dyspnea, and possibly fever.
Patient Care. Goals and outcome criteria for planning and interventions to prevent, minimize, or alleviate ineffective airway clearance will depend on the patient's medical diagnosis, specific nursing diagnoses, and related pathophysiology. In general, the goals are to promote the movement of air in and out of the lungs; prevent development of infection, atelectasis, and accumulations of stagnant secretions in the lungs; and encourage preventive and therapeutic pulmonary hygiene to maintain good ventilation.

Some appropriate nursing interventions to accomplish these goals might include teaching the patient effective coughing practices, assisting with postural drainage and other techniques used by the respiratory therapist to remove secetions from the respiratory tract, helping the patient to stop smoking, helping the patient identify and avoid allergens in the environment, maintaining a clean and infection-free environment, repositioning and encouraging early ambulation in post-surgical patients, and providing instruction in ways to avoid extreme fatigue in patients with chronic obstructive pulmonary disease.
conducting airway the lower and upper airways together, from the nares to the terminal bronchioles.
lower airway the airway from the lower end of the larynx to the ends of the terminal bronchioles.
upper airway the airway from the nares and lips to the larynx.

air·way

(ār'wā),
1. Any part of the respiratory tract through which air passes during breathing.
2. In anesthesia or resuscitation, a device for correcting obstruction to breathing, especially an oropharyngeal and nasopharyngeal airway, endotracheal airway, or tracheotomy tube.

airway

/air·way/ (-wa)
1. the passage by which air enters and leaves the lungs.
2. a device for securing unobstructed respiration.

esophageal obturator airway  a tube inserted into the esophagus to maintain airway patency in unconscious persons for positive-pressure ventilation through the attached face mask.
conducting airway  the upper and lower airways considered together.
laryngeal mask airway  a device for maintaining a patent airway without tracheal intubation, consisting of a tube connected to an oval inflatable cuff that seals the larynx.
lower airway  the airway from the inferior end of the larynx to the ends of the terminal bronchioles.
nasopharyngeal airway  a tube inserted through a nostril, across the floor of the nose, and through the nasopharynx so that the tongue does not block air flow in an unconscious person.
oropharyngeal airway  a tube inserted through the mouth and pharynx so that the tongue does not block air flow in an unconscious person.
Airway. Oropharyngeal airway in place.
upper airway  the airway from the nares and lips to the larynx.

airway

Etymology: Gk, aer + AS, weg, way
1 a tubular passage for movement of air into and out of the lung. An airway with a diameter greater than 2 mm is defined as a large, or central, airway such as a mainstream bronchus; one smaller than 2 mm is considered a small, or peripheral, airway such as a terminal bronchus.
2 a respiratory anesthesia device.
3 an oropharyngeal tube used for mouth-to-mouth resuscitation.

air·way

(ār'wā)
1. Any part of the respiratory tract through which air passes during breathing.
2. anesthesia During resuscitation, a type of device to correct obstruction to breathing, especially an oropharyngeal, nasopharyngeal, or endotracheal airway, or tracheotomy tube.

airway

(ar'wa?)
1. A natural passage for air to enter and exit the lungs.
2. A device to prevent or correct an obstructed respiratory passage, esp. one inserted into the trachea and used during anesthesia or cardiopulmonary resuscitation. An open airway is essential to oxygenation and ventilation. Methods for opening the airway are described in the following entries: cardiopulmonary resuscitation; chin-lift airway technique, head tilt; jaw thrust; tracheostomy. The following subentries highlight commonly used airways in advanced cardiac life support. None of them have been proven to enhance the survival of patients who suffer sudden death in the field. See: jaw thrust

CAUTION!

If a patient has a mechanism of injury involving potential trauma to the clavicles or above, the airway should be opened only with the jaw thrust maneuver.

Combitube airway

A trademark for a dual-lumen airway consisting of a tracheal tube linked to an esophageal tube. It may be inserted blindly into the oropharynx as an airway control device when an endotracheal tube is not available or when tracheal intubation with direct visualization of the vocal cords is challenging.

difficult airway

An airway that is challenging or impossible to intubate. Intubation is increasingly difficult in: older patients, patients with head or neck trauma, obese patients, and patients with craniofacial abnormalities.

esophageal gastric tube airway

Abbreviation: EGTA
esophageal obturator airway.

esophageal obturator airway

Abbreviation: EOA
An airway device (formerly used in EMS systems) consisting of an esophageal tube with a 37-cm long tube attached to a mask. To be effective, the device requires an airtight mask seal on the patient’s face. A balloon at the distal end of the tube is inflated following blind insertion into the esophagus. The device reduces the likelihood of regurgitation and aspiration of stomach contents and indirectly ventilates the lungs.

CAUTION!

Most emergency service agencies have replaced this device by more-advanced airway devices.
Synonym: esophageal gastric tube airway

laryngeal mask airway

Abbreviation: LMA
An airway that can be blindly inserted into the hypopharynx to use when advanced airway control is needed during procedures that require brief anesthesia. It consists of an airway tube with a proximal cuff, which holds the middle of the tube in place at the base of the tongue, and a distal cuff to fix the end of the tube in the trachea.

CAUTION!

It should not be used in patients at high risk of aspiration.
Synonym: laryngeal tracheal airway

laryngeal tracheal airway

Abbreviation: LTA
Laryngeal mask airway.
Enlarge picture
NASOPHARYNGEAL AIRWAY: A nasopharyngeal airway in proper position

nasopharyngeal airway

Abbreviation: NPA
A soft, flexible, uncuffed tube placed through the nasal passages so that the distal tip rests in the nasopharynx. It is used to maintain the free passage of air to and from the lungs in patients with facial trauma or lockjaw or in nearly comatose patients who are breathing spontaneously. Before the tube is inserted, the proper length is determined by comparing it to the distance from the tip of the patient's nose to the earlobe. The diameter should match that of the patient's pinkie. Nasopharyngeal airways are often used by respiratory therapists to reduce the trauma from repetitive nasotracheal suctioning. Synonym: nasal trumpetillustration;

CAUTION!

Bleeding from the nasopharynx may occur during emergency placement of this airway.
illustration
Enlarge picture
OROPHARYNGEAL AIRWAY: An oropharyngeal airway in place

oropharyngeal airway

Abbreviation: OPA
A curved plastic device used to establish an airway in a patient by displacing the tongue from the posterior wall of the oropharynx. The device should be equal in length to the distance either from the corner of the mouth to the earlobe or from the center of the mouth to the angle of the jaw. It has a flange on the end that remains outside the mouth to keep it from being swallowed or aspirated. This device is used only in unconscious patients who do not have a gag reflex.cardiopulmonary resuscitation; illustration;

CAUTION!

The head of an unconscious patient should be stabilized before the airway is inserted to reduce the likelihood of cervical spinal cord injury and paralysis.

supraglottic airway

Supralaryngeal airway.

supralaryngeal airway

A device used as an alternative to tracheal intubation in the ventilation of the critically ill. It contains both an esophageal and a tracheal lumen and may be inserted without visualization of the vocal cords.
Synonym: supraglottic airway

airway

1. The passages from the nose and mouth down to the air sacs in the lungs, by way of which air enters and leaves the body.
2. A curved plastic air tube often used by anaesthetist to prevent the tongue from falling back and obstructing breathing.

airway

device used to maintain free passage or prevent obstruction of air through the respiratory tract

air·way

(ār'wā)
1. Any part of the respiratory tract through which air passes during breathing.
2. In anesthesia or resuscitation, device to correct obstruction to breathing, especially an oropharyngeal and nasopharyngeal airway, endotracheal airway, or tracheotomy tube.

airway,

n 1. a clear passageway for air into and out of the lungs.
2. a device for securing unobstructed respiration during general anesthesia or in states of unconsciousness.
airway, chin lift,
n a method of opening the trachea of an individual by manually changing the position of his or her head in order to perform rescue breathing.
airway obstruction,
n an abnormal condition of the respiratory pathway characterized by a mechanical impediment to the delivery or to the absorption of oxygen in the lungs, as in choking, bronchospasm, obstructive lung disease, or laryngospasm.
airway obstruction, chest thrust,
n an alternate method of removing an obstacle lodged in the airway by compressing the sternum; used when pregnancy or a patient's body size render the Heimlich maneuver impossible or inappropriate. See Heimlich maneuver.
airway obstruction, infant chest thrust,
n a method of removing an obstacle lodged in the airway of an infant by placing the child facedown along the forearm and striking the child's back with the opposite hand. See Heimlich maneuver.
airway resistance,
n the ratio of pressure difference between the oral cavity, nose, or other airway opening and the alveoli to the simultaneously measured resulting volumetric gas flow rate.

airway

1. the passage by which air enters and leaves the lungs.
2. a mechanical device used for securing unobstructed respiration during general anesthesia or other occasions in which the patient is not ventilating or exchanging gases properly. Includes an endotracheal tube and a tracheostomy tube.

artificial airway
endotracheal or tracheostomy tubes.
airway obstruction
in the unanesthetized animal is usually caused by vomitus or laryngeal spasm due to foreign material in the larynx. In the nonintubated anesthetized animal, it is caused by caudal displacement of the tongue and epiglottis, accumulation of mucus, saliva and blood in the pharynx or laryngeal spasm resulting from that accumulation. In the intubated animal, faulty placement or functioning of the endotracheal tube or kinking of it can cause obstruction of the airway. The signs of obstruction are deep, asphyxial respirations, struggling and great agitation in the conscious animal. Deeply anesthetized animals simply show a decline in respiratory efficiency.
airway reflexes
aid in the removal of secretions and foreign material. See also cough, sneeze.
airway resistance
the resistance to airflow through the respiratory tree and any addition to the airway, such as the endotracheal tube and connectors in a closed circuit anesthetic machine.