Advanced Life Support

| In Articles | 1st June 2020

Airway management

  • Supplemental oxygen
  • Facial mask
  • Self inflating bag
Self inflating bag for life support
  • Simple airway adjuncts: oropharyngeal airway
  • Simple airway adjuncts: nasopharyngeal airway
nasopharyngeal airway
  • Tracheal tube
  • Laryngeal mask airway
  • Combitube

  • Magill forceps
  • Laryngoscope
Laryngoscope used in advanced life support
  • Cricotiroidotomy kit
advance life support kit
  • Large bore suction catheter (Yankauer)
Large bore suction catheter
suction catheter for advance life support
  • Vacuum cleaner
vacuum cleaner

Tracheal intubation in advanced life support

Laryngoscopy and intubation of the trachea should not last longer than 30 seconds. Any doubt about the correct placement of the tube in the trachea leads to tube withdrawal and re-oxygenating the patient before further attempts.

Tracheal intubation advantages

  • Allows ventilation with up to 100% oxygen
  • Isolates airway, preventing aspiration
  • Allows suction of the airway
  • The release of a resuscitation team member

Tracheal intubation limitations

  • Training and experience essential
  • Failed insertion
  • Could worsen cervical or head injury

Confirming correct placement of a tracheal tube

  • Direct visualisation at laryngoscopy
  • Ascultation (bilaterally, mid-axillary line, over the epigastrium)
  • Symmetrical movement of the chest during ventilation
  • Capnometry (recording the carbon dioxide concentration of exhaled air at the patient's airway using a capnometer)

Tracheal intubation - accidents, incidents

  • Dental fractures
  • Vomiting and regurgitation
  • Trismus (spams of the jaw muscles)
  • Oesophageal intubation
  • Cervical spine lesions

Sellick maneuver - Cricoid pressure

The application of pressure to the cricoid cartilage of the neck and consequently blocking the oesophagus which passes directly behind it.

Needle cricothyrotomy in advanced life support

Indicated in case of failure to provide an airway by any other means


  • Incorrect position of the cannula
  • Emphysema
  • Haemorrhage
  • Oesophageal perforation
  • Hypoventilation
  • Barotrauma (change in air pressure affecting the ear or lung)

Ventilation in advanced life support

  • Mouth to mask ventilation
ventilation mouth to mouth
  • Self inflating bag
self inflating respiratory bag
  • Supraglottic airways: laryngeal mask airway LMA
airway with laryngeal mask
  • Supraglottic airway: i-gel
  • Supraglottic airway: laryngeal tube
respiratory tube
  • Ventilators
Life Support ventilator for ventilation