EMT Lesson Plans

2.03 INSTRUCTOR GUIDANCE – SURGICAL AIRWAY

Objectives: Demonstrate connecting a BVM to a stoma Demonstrate superficial suctioning of a surgical airway

Setup:

- Oxygen system with BVM - Stoma manikin (Adult)

Instructions to be read to students: “I am going to demonstrate how to set up and work with a stoma or tracheostomy patient.”

Discuss the difference between a stoma and a tracheostomy

Please the manikin in a chair or on a surface. Demonstrate and have students practice the following:

- Application of a stoma oxygen mask (4-10 liters) - how to hook up a BVM to the stoma - suctioning the outside of the appliance with a French catheter.

Precautions: Do not let the station deteriorate into chatter. Continue rotating them through one at a time until everyone has done all three skills.

!!!!! IMPORTANT !!!!! The EMT Educational guidelines only list “suctioning of the upper airway” as an EMT skill, and they list “Tracheobronchial suctioning” as an Advanced EMT skill (we don’t have AEMTs in NJ). As a result, deep tracheobronchial is out of an EMT’s scope of practice. The current EMT book encourages EMTs to “suction the stoma and the mouth with a French or soft-tip catheter”. We will interpret that as suctioning the device/orifice but not so deep that it is indwelling in the trachea. Please use 1” of less of French catheter insertion into the manikin so that we can assure the catheter is suctioning the device and not the trachea.

Please note the following:

Make sure students understand:

- Tracheostomies have tubes that seal off the upper airway – you CANNOT ventilate the mouth/nose is these patients - People who have cancers of the larynx sometimes have to have those structures removed and end up with stomas. They might breathe just fine. If they need ventilation, the preferred order is:

o Ventilate stoma with close mouth/nose – round infant mask might be helpful

o Ventilate mouth/nose with stoma occluded.