1-1

Key basic plan

This Key Basic Plan will detect and identify almost all initial problems, allowing you to fix or temporise. There are specific drills for specific problems later on in the QRH. Using the same systematic approach: increases the chance of identifying the problem, reduces the risk of missing the problem, limits fixing attention inappropriately.

START.
1
Adequate oxygen delivery
2
Airway
3
Breathing
4
Circulation
5
Depth
6
Consider surgical problem
7
Call for help
Box A CRITICAL CHANGES

If problem worsens significantly or a new problem arises, call for help and go back to START of key basic plan.

Box B ADEQUATE OXYGEN DELIVERY

Altering fresh gas flow may require change of vaporiser setting.

Box C AIRWAY

Noise: Listen over the larynx with a stethoscope to get more information (e.g. leak / obstruction).

Tracheal tube: You can pass a suction catheter to check patency.

Box D ISOLATE EQUIPMENT

Ventilate lungs using self-inflating bag connected DIRECTLY to tracheal tube connector.

DO NOT use the HME filter, angle piece or catheter mount.

If increased pressure manually confirmed, re-connect machine.

If increased pressure NOT manually confirmed, assume problem with machine/circuit/HME/filter/angle piece/catheter mount: check and replace as indicated.

Box E BREATHING

Remember that airway 'feel' depends on your APL valve setting and fresh gas flow.

You can only "feel" a maximum of what the APL valve is set to. Measured expired tidal volume gives additional information.