Emergency Airway + Ventilation Course

About the course

*Exposure to settings where patients are intubated and ventilated is required either before or immediately after the course for optimal learning.  This course has been adapted to meet the needs of the critically ill COVID-19 patient

This three-day simulator-based course is designed to teach the knowledge, skills and attitudes required to safely intubate and ventilate critically ill patients in any setting. The course is taught by an experienced faculty using small groups and patient simulators, who facilitate delegates to build their competence through realistic scenarios.

Who is Emergency Airway + Ventilation Course for?

The Emergency Airway + Ventilation Course is designed to meet the learning needs of the health workforce working in emergency and critical care settings (Nurses, Clinical Officers and Medical Officers) who may be required to intubate and ventilate critically ill patients.

Course Delivery

The Emergency Airway + Ventilation Course consists of the following components:

  • Pre-course learning reading material (DOWNLOAD)
  • Pretest multiple-choice quiz (MCQ)
  • Attendance at three (3) day face to face workshop consisting of skill stations and practical based scenarios
  • An individual scenario-based clinical skills assessment
  • Multiple-choice post-test (MCQ)

Workshop Format

The 3-day face to face workshop consists of short, focused discussions with real-time practical demonstrations followed by hands-on-practice sessions under the guidance of experienced emergency and critical care experts.

Ratio = 6 participants per 2 faculty, maximum – 12 participants. This is a 3-full day workshop.

Emergency Airway + Ventilation Course Graduates will:

  • Describe and implement a systematic patient assessment approach to the acutely ill patient needing oxygen
  • Demonstrate the use of different oxygen delivery devices
  • Demonstrate principles of basic and advanced airway management of the critically ill patient and the use of airway adjuncts e.g. OPA and NPAs, the bag-valve-mask (BVM), and supraglottic devices e.g. LMAs
  • Demonstrate competence in the following airway skills required to support the critically ill patient; giving oxygen, insertion of airway adjuncts NPAs and OPAs, Bag-valve-mask ventilation, Rapid Sequence Intubation (RSI), insertion of an LMA
  • Explain the different types of ventilation and ventilation settings
  • Demonstrate competence in skills required to set up a ventilator for different patients and troubleshoot a ventilator
  • Demonstrate knowledge and skills in the management of the intubated and ventilated patient

On successful completion, the participants will be awarded

An Emergency Airway + Ventilation Course  certificate (valid for two years)

Contact us

If you have any queries about the course or its relevance to your practice or facility, please contact us at emkf@emkfoundation.org

The Team

Dr Idris Chikophe, Consultant Anaesthetist and Critical Care Specialist
Dr Benjamin W Wachira, Emergency Physician
Dr Ifrah Hersi, Consultant Anaesthetist

Non-Invasive Ventilation

Noninvasive ventilation decreased endotracheal intubation rates and hospital mortality in acute hypoxemia non-hypercapnic respiratory failure excluding chronic obstructive pulmonary disease exacerbation and cardiogenic pulmonary edema patients. There is no sufficient scientific evidence to recommend bi-level positive airway pressure or helmet due to the limited number of trials available. Large rigorous randomized trials are needed to answer these questions definitely.

 

Optimal Bag-Valve-Mask Ventilation

Sexy Bagging

 

  1. Remember to connect the device to an Oxygen Supply
  2. Use two providers wherever possible – one to maintain a good seal by lifting the face into the mask and applying a steady downward counter pressure to the mask using both hands (see image) and the other colleague squeezes the bag to ventilate.
  3. Don’t ‘bag’ too fast or hard – we recommend aiming for 1 breath every 6 seconds and just enough volume to make the chest rise (it’s a patient, not a balloon)
  4. Patients receiving BVM for cardiac arrest can do as well if not better than those who are intubated (there is NO EVIDENCE that use of an advanced airway in resuscitation saves lives)

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Emergency Ventilation

BMV is always a 2 person procedure (regardless of technique used) – Skilled person holds the mask and anyone else can provide the breaths + Consider the 2 thumbs down technique for BMV instead of the CE clamp. And Believe it or Not – Learning BMV is more important than mastering Laryngoscopy !!

NIV: What’s the big deal?

 

Terminology:

In general,
Type 1 RF requires CPAP type of NIV.

Type 2 RF requires BPAP type of NIV.

PEEP=EPAP=CPAP i.e. they all mean the same!

So you can say in Type 1 RF(Hypoxic failure), the pressure we provide is PEEP or just EPAP or CPAP. 

For Type 2 RF (Hypercapnic), we provide IPAP as well as EPAP. IPAP is greater than EPAP, PS (Pressure Support is the difference between IPAP and EPAP). For instance if IPAP = 15 and EPAP is 10 then PS = 15-10 i.e. 5cm H2O.

Mechanical Ventilation- Terminology

Volume controlled ventilation

We can put a certain volume of air into the patient with each breath in mechanical ventilation.

Pressure controlled ventilation

We can put air into the patient until the pressure reaches a certain value.

Rate

We can decide how often we give the patient a breath each minute.

Flow rate

For example, we can give a certain volume of gas , but the flow rate will determine whether we give that volume slowly or quickly over that breath.

FiO2

In other words, the oxygen concentration we give to the patient, from 21% (room air) to 100%.

What triggers the breath?

Do we have the patient decide when they want to breathe, or do we have the ventilator decide when to initiate a breath? Or indeed a combination of the two? Is it ventilator controlled or patient controlled?

 

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Understanding intubation and ventilation…the Pearls and Pitfalls

A normal minute ventilation involves a minute ventilation between 5 and 8 L [ie, 500–600 mL, rate 10–14 breaths/minute]. In severely ill COPD and asthma patients, overventilation risks auto-PEEP and barotrauma; a starting rate of six breaths with a 500 mL volume allows maximum time for exhalation.

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