What does Airway Management Mean to You?

Airway management is really a very broad spectrum term. To most people in healthcare it means simply putting in an endotracheal tube, but there really is a lot more to it than that. Our airway consists of everything from our oral opening all the way down to the small distal terminal bronchioles. Placing an endotracheal tube only involves a small part of that airway. Well, what happens before the tube gets placed? What happens after the tube gets placed? Does the skill of airway management not exist if the tube is not actually being placed at the moment? I hardly think so.

To me airway management means a lot more than simply placing a tube in a patients airway. To manage ones airway is to manage the entire airway; its patency, its function, and the patients ability to use it properly. Here’s an example. At my facility it is not uncommon for me to get a call to a patients room to stand by while a cardiologist performs a transesophageal echocardiogram, or TEE. As a Respiratory Therapist the purpose of my presence during a cardiac procedure to be sure that the patient will continue to breathe effectively during the procedure. That is airway management. If the patients’ oxygen saturation declines then I am to increase supplemental oxygen until the oxygen saturation increases to a safe level. That too is airway management. If the patient stops breathing effectively then I am to breathe for them via bag-valve-mask ventilation until they start breathing on their own. That too is airway management. If the patient has a reaction to some of the medication he or she is given and their airway gets tight, as in asthma like symptoms, then I am to give bronchodilators. That too is airway management. As a last resort, to be certain that the benefit outweighs the risk under the current circumstances, then I am to intubate the patient. That, we all know, is airway management. I can go on and on but you get the idea now, right? Airway management is a broad field that involves a lot of tasks based on educated decisions. Airway management is taking care of a patients’ entire airway, how they’re using it, and how it’s functioning. Airway management is “A” and “B” of the ABC’s, and it just happens to be where we, as Respiratory Therapists, specialize. For that reason alone we are in every area of healthcare with a very important role; Airway management. “Because at the head of every team is a Respiratory Therapist”…

J. D’Urbano
BreathSounds, and The RT’s Report Room
http://www.BreathSounds.org
http://www.BreathSounds.org/ReportRoom/
“Because at the head of every team is a Respiratory Therapist”