SS-1

Basic Airway Skills & Circulation

30 minute session

Utilizing Airway Trainer Manikin, practice:

1. Head tilt, chin lift, jaw thrust. Warn to avoid head tilt and neck lift
2. Correct airway maintenance will be shown by succesful mouth to mask
ventilation. Demonstrate that neck flexion may obstruct the airway.
3. In-line immobilisation of the neck, new method
4. Insertion of oropharyngeal tube
5. Insertion of nasopharyngeal tube
6. Suctioning of pharynx
7. Placing O2 mask and give 5-8 lpm flow. Warn no to use nasal prong.
Demonstrate alternative home-made mask
8. Ventilating mouth to mask.
9. Ventilating using Ambu bag to mask. Demonstrate correct volume (chest
just rise = 500-600 ml). Demonstrate how over ventilation insufflates
stomach.
10.Insertion of nasogastric tube

Utilizing Infusion Trainer Arm, practice:

1. Inserting large bore iv canula, connect infusion line
2. Inserting intraosseus needle may be practiced using chicken bone or
pediatric leg model.
3. This section may be substituted by poster viewing
 SS-2
Advanced Airway Skills
30 minute session

Utilizing Airway Trainer Manikin, practice:

1. Laryngoscopy and tracheal intubation

a. Placing the small pillow underneath head
b. Laryngoscopy, viewing glottis without due trauma
c. Sellick maneuvre
d. Insertion of tracheal tube, inflate cuff, give ventilation, check chest rise &
symmetry.
e. Insertion of oropharyngeal tube as bite block

2. Cricothyroidotomy
a. Demonstration of the location of cricothyroidotomy using either each-
other’s neck, the larynx model or Airway Trainer
b. Demonstration of needles available, connection to side-hole injection
syringe attached to oxygen line. Do not use 3-way stopcock and lines.

3. Laryngeal mask
a. Correct deflating and proper profile of the cuff. DO NOT USE silicon
spray lubricant. Use KY jelly sparingly
b. Insertion of the LMA using index finger guide from either cranial and
caudal approach, inflate properly.

4. Ventilation using Ambu bag and Jackson Reese (if oxygen available)
 SS-3
Positioning & Transportation
30 minute session

Utilizing full-body manikin or any adult student, practice:

1. Laying the victim supine on hard surface or spine board, neck in neutral
position.
2. Shock position
3. In-line neck immobilisation
4. In-line immobilisation and placing neck collar (2 types)
5. Placing sandbags and chin-tape
6. Insertion of oro / nasopharyngeal tube
7. Full face helmet removal
8. Log-roll
9. Placing pelvic belt / sling with minimum movement
10.Applying elastic compression bandage on head, arm, leg on each other
(try multiple bandage on multiple students).
Demonstrate proper tightness.
11.Shifting victim from / to stretcher.
 SS-4
Pneumothorax management
30 minute session

Utilizing the Pneumothorax Trainer Manikin, practice:

1. Needle thoracostomy on 2nd intercostal space at mid-clav line using

needle-syringer-water technique. Remind the big needle angle of entry
and depthness of 3-5 cm depending on victim’s posture.
2. Preparing the Water-Sealed-Drainage bottle, connection line to thorax
drainage
3. Demonstration of tube thoracostomy at 5th intercostal space at anterior
axillary line. Stressing on:
a. Do good incission until opening the pleural cavity. Open pneumothorax
thus created is better than tension pneumothorax. Patient should receive
oxygen all the time.
b. Insertion of thoracic tube without the metal introducer. Last distal hole
should be inside the pleural cavity.

4. Closing open thorax wound or sucking wound with plastic sheet taped on
3 sides.
5. Applying wide adhesive tape for fixing flail-chest