Cardiopulmonary resuscitation (CPR) is an emergency procedure performed in case of medical emergencies like cardiac arrest. However, how does the procedure differ when an advanced airway is in position? An endotracheal tube or Supraglottic airway is an example of an advanced airway that changes traditional CPR methods to achieve effective ventilation and circulation. This article will discuss the differences, benefits, and best practices for CPR with an advanced airway.
Advanced CPR Understanding Techniques
Rest assured, there are means of medically enhancing a patient’s airway to assist them in breathing. As such, definitive means of oxygen supplementation are required for critical scenarios needing prolonged resuscitation. Enhancements to breathing tubes can be made using:
Endotracheal tube (ETT): It’s installed into the trachea to assist patient ventilation.
Tracheostomy tube: These are surgically put in place for patients who direly need safe simplified access to the airway.
Supraglottic airway devices: These include Laryngeal mask airways (LMAs) or King airways that are positioned over the vocal cords.
Best Practices and Key Differences in CPR with an Advanced Airways
Unlike conventional CPR where breathing is held through chest stuffing with compressions, ETT in position allows the procedure to be done simultaneously. Some aspects are as follows:
Ventilation and chest stuffing:
- It can be done together. Breathtaking and continuous stuffing can be done for the chest while keeping a pace of 100-120 bmp.
- Compliance at an unvarying pace of one breath every 6 seconds (10 breaths per minute). There’s no need to pause compressions for breaths, thus getting rid of a check-in possible recirculation.
Modified compression-to-ventilation ratio:
- In standard CPR (without an advanced airway), a 30:2 compression-to-ventilation ratio is used for adults.
- With an advanced airway, The compression rate remains at 100-120 per minute. Also, ventilation is given by dividing it into 2 periods, without stopping compressions.
Airway management becomes a priority.
- Advanced airways prevent aspiration and allow for better oxygenation and ventilation.
- Rescue breaths can be performed more easily than with a bag-mask device.
- Trained personnel must ensure proper placement of the airway so it does not become displaced.
Benefits of Performing CPR with an Advanced Airway
| Benefit | Explanation |
| Improved Oxygenation | Delivers higher oxygen concentration directly to the lungs. |
| No Pauses for Ventilation | Ensures continuous circulation and perfusion. |
| Lower Aspiration Risk | Prevents gastric contents from entering the lungs. |
| Better Airway Control | More stable airway management in prolonged CPR efforts. |
FAQs
How does an advanced airway change the compression-to-ventilation ratio in CPR?
With patients with an advanced airway, the former 30:2 ratio no longer applies. Instead, chest compressions remain at a rate of one hundred to one hundred twenty compressions per minute while ventilations are given every six seconds.
What is the problem with practicing CPR with an advanced airway?
Some of the risks that may be present are airway displacement, too much breath being given, and excess pressure in the thorax which may cause less blood to be returned to the heart.
Can CPR be done if there is a tracheostomy tube in place?
Yes, CPR is similar in principle. Ventilations need to be given directly into the tracheostomy tube at the correct rate.
How does a rescuer verify the proper placement of an advanced airway?
Verification is achieved through monitoring bilateral chest rise, auscultation, and ETCO2 capnography.
At what rate is ventilation done when an advanced airway is used?
It is set at one breath every six seconds, which amounts to ten breaths in a minute. This is sufficient to provide oxygen without causing hyperventilation.
Conclusion
How does the provision of CPR change with the use of an advanced airway? The most important changes consist of mandatory chest compressions, stopping only for passive ventilation, increased control ventilation frequency that is set at one every six seconds, and ETCO2 monitoring. These methods ensure that oxygen delivery is improved and interruptions are reduced, which enhances the chances of survival. Making sure people know these guidelines helps trained personnel and healthcare practitioners provide optimum CPR during emergencies.
