Airway obstruction

[Olliedo]

Although I’ve got 4 years of experience of nursing in PCU, I am really new to the world of PACU. While on my own, I had removed a pillow under a pts head that was coming in because they had an oral airway and I didn’t see the fog in their mask, so I assumed they were obstructing. Anesthesiologist was wondering why I removed the pillow when they had an airway in. Is it possible to still obstruct your airway with any type of airway in? Or did I just not notice his/her breathe coming through the mask? I know airway is the biggest thing and I want to make sure I do a good job. Any other pacu tips are welcomed as well.

[IMOKAY, BSN]

Yes a pt airway can obstruct even with oral airway. You can readjust pt head til you see fog in mask or they may need mandible support , jaw thrust. A pillow in the right place can help keep airway open as well.

If pt is loud snoring even with fog in mask I will try to adjust pt head so airway allows more flow. This is difficult in short neck, pt with OSA and/or obesity.

[Lowcenseme]

Is it better to have a pillow or no pillow?

[IMOKAY, BSN]

It depends on the situation. Use the pilliow as a tool under shoulders so head falls back with airway patent if needed. But, If pillow causing obstruction, may need to remove it.

[Nurse Gonzo, BSN, RN]

I, too, tend to prefer the pillow under the shoulders depending on the circumstance because it aids in propping the head back. Never assume that an airway is the end all-be all of keeping the patient oxygenated. Sounds like you did perfect!