The next video that you watch is the airway video, you'll also be performing your basic airway adjunct skills during this video. And we're gonna get into that here in just a moment. But if you think about it, airway is really important. Obviously, it is secondary to chest compressions, but airway is again equally as important. So one thing to consider is oxygen saturation. The American Heart Association recommends that if your patient is on room air, and their otu status between 94 and 99%, they do not require supplementary oxygen, so 94 to 99%.

They don't require supplementary oxygen, obviously, if it's less than 94%. They want you to provide some type of oxygen to keep that patient oxygenated. One of the things that the American Heart Association is concerned about his reperfusion injury, especially in the post cardiac arrest phase. So what they're telling us is that, hey, if we give, you know large amounts of concentrated oxygen over long periods of time to a patient that simply just doesn't need it anymore, that can be harmful to them and that can cause what they're going to call oxygen toxicity. So just kind of keep that in mind. The next segment we'll talk about is your skills.

Check off with the oral airway and the nasal airway. The first device that we'll speak of is the NPA or the nasal pharyngeal airway. The nasal pharyngeal airway is meant to go into the patient's nostril and just bypass the Tom and it is it's meant to create a more paitent airway. You can use that nasal airway on a patient who is semi conscious or unconscious depending on what is going on with your patient. So the steps to inserting an NPA or nasal pharyngeal airway is this. Step number one, you'll choose the correct size of the NPA In order to make sure that the NP is going to be perfect for that patient is you want to start with the flange or the flat part at the tip of the patient's nose.

And you want it to measure and have it end up where the earlobe meets the mandible at the angle of the jaw. So once that is the right size, you have chosen the correct NPA. for that patient. You'll need to use some lubrication, copious amounts of lubrication. And then you'll introduce the NPA into the nostril it doesn't matter which nostril you use, just pick one and I like to tell people just to put the bevel towards the septum slowly introduced the NPA in a in a slight twisting fashion until the bevel or the flat part is up against the nose. Now you have the NPA airway.

You can also use this airway for suctioning the court the oropharynx if you wish, it's actually a great method for that. So the next basic airway adjunct we'll talk about is going to be the Pa are the oropharyngeal airway. This should be used keep in mind on people that are completely unconscious because if you go and put one of these oral airways into unconscious or semi conscious patient, then you could cause a gag reflex and therefore vomiting and then we might have an aspiration issue. So we have to make sure that they're that they're really unresponsive. How do we choose the right size? Well, they come in a bunch of different sizes, and they're all color coded.

But what you want to do is pick the one that you think is going to work the best. And then we want to measure it to see if it's going to fit the patient. And what we'll do is we'll put the flat part towards the corner of the mouth. And we want the end of that to be right where the angle of the jaw is where the ear lobe meets the mandible. As long as it fits nicely there. Then we have the correct size.

Now there are a bunch of different ways to put in the PA. I like to put it in upside down like this, and then introduce it about halfway into the patient's mouth. And then twist it 100 Than 80 degrees, so it kind of flops the tongue out of the way, and keeps that tongue off the back of the throat, therefore creating an airway. So that's the best way I know how to do it. Now once you've got the the nasal airway, or the oral airway inserted, you'll want to use bag mass ventilations. If you're alone, obviously, we have to be at the patient's head.

And we'll do what they call the C to E clamp method, the C is going to get your seal and the the other three fingers is actually going to tilt that head back and open up the airway. And then once that is open, we're going to get a good seal on the mask. And we'll just squeeze making sure that the chest rises. If the chest doesn't rise, then we haven't gotten an air into that patient and we just need to maybe readjust or take our or check, check our seal once again. The best way to deliver bag mask ventilation is with a two person technique. It's the best seal you're ever going to get.

So what you have is one person who's at the head and they're going to take both of their hands and they're going to do the doubles. CD clamp method, getting that seal and opening up the airway on the patient and another person will be squeezing that bag. This again this is the best way to deliver oxygen to a patient is using the double CD clamp.