airway

Oropharyngeal Airway. This device is inserted into the mouth to prevent the tongue from obstructing the pharynx.

Esophageal Obturator Airway. This is a hollow tube inserted into the esophagus to maintain airway patency in unconscious persons and to permit positive-pressure ventilation through the face mask connected to the tube. It was designed to be used by trained pre-hospital medical personnel to establish an airway. Its use has declined because of training of pre-hospital medical personnel in the insertion of endotracheal tubes, and because studies have suggested poor performance.

Esophageal Gastric Tube Airway. This is a hollow tube with a balloon at the end, which is blindly inserted into the esophagus, obstructing the esophagus and theoretically forcing air into the trachea, thus decompressing the stomach and alleviating abdominal distention; it represents an improvement in the design of the esophageal obturator airway. Ventilation occurs in the oropharynx.

Nasopharyngeal Airway. This is a hollow tube placed through the nose into the nasopharynx to bypass upper airway obstruction or to decrease trauma from nasotracheal suctioning.

Endotracheal Tube (or Airway). This inflatable tube is inserted into the mouth or nose and passed into the trachea to provide mechanical ventilation, to provide a suction route, to prevent aspiration of stomach contents, and to bypass upper airway obstruction.

Tracheostomy. This involves a surgical incision into the trachea and insertion of a metal or plastic tube through the incision. (See also tracheostomy.)

Patient Care. Goals and outcome criteria for planning and interventions to prevent, minimize, or alleviate ineffective airway clearance will depend on the patient's medical diagnosis, specific nursing diagnoses, and related pathophysiology. In general, the goals are to promote the movement of air in and out of the lungs; prevent development of infection, atelectasis, and accumulations of stagnant secretions in the lungs; and encourage preventive and therapeutic pulmonary hygiene to maintain good ventilation.

Some appropriate nursing interventions to accomplish these goals might include teaching the patient effective coughing practices, assisting with postural drainage and other techniques used by the respiratory therapist to remove secetions from the respiratory tract, helping the patient to stop smoking, helping the patient identify and avoid allergens in the environment, maintaining a clean and infection-free environment, repositioning and encouraging early ambulation in post-surgical patients, and providing instruction in ways to avoid extreme fatigue in patients with chronic obstructive pulmonary disease.