Oxygen must never be used near open flames sinceit supports burning. Oxygen cylinders must be handledcarefully since they are potentially lethal missiles ifpunctured or broken.ARTIFICIAL AIRWAYSThe oropharyngeal and nasopharyngeal airwaysare primarily used to keep the tongue from occluding(closing) the airway.Oropharyngeal AirwayThe oropharyngeal airway can be used only onunconscious victims because a conscious person willgag on it. This airway comes in various sizes fordifferent age groups and is shaped to rest on thecontour of the tongue and extend from the lips to thepharynx. Selecting the correct size oropharyngealairway is very important to its effectiveness. Anairway of proper size will extend from the corner of thepatient’s mouth to the tip of the earlobe on the sameside of the patient’s face.One method of insertion is to depress the tonguewith a tongue blade and slide the airway in. Anothermethod is to insert the airway upside down into thevictim’s mouth; then rotate it 180as it slides into thepharynx (fig. 4-20).Nasopharyngeal AirwayThe nasopharyngeal airway may be used onconscious victims since it is better tolerated because itgenerally does not stimulate the gag reflex. Since it ismade of flexible material, it is designed to belubricated and then gently passed up the nostril anddown into the pharynx. If the airway meets anobstruction in one nostril, withdraw it and try to pass itup the other nostril. See figure 4-21 for properinsertion of the nasopharyngeal airway.BAG-VALVE MASK VENTILATORThe bag-valve mask ventilator (fig. 4-22) isdesigned to help ventilate an unconscious victim forlong periods while delivering high concentrations ofoxygen. This system can be useful in extended CPRattempts because, when using external cardiaccompressions, the cardiac output is cut to 25 to 30percent of the normal capacity, and artificialventilation does not supply enough oxygen through thecirculatory system to maintain life for a long period.Various types of bag-valve-mask systems thatcome in both adult and pediatric sizes are in use in theNavy. Essentially, they consist of a self-fillingventilation bag, an oxygen reservoir, plastic facemasks of various sizes, and tubing for connecting to anoxygen supply.4-26Figure 4-20.—The rotation method of inserting anoropharyngeal airway.Figure 4-21.—Proper insertion of a nasopharyngeal airway.Figure 4-22.—Bag-valve mask ventilator.
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