BASIC AIRWAY MANAGEMENT
The majority of preventable deaths following trauma occur as a result of airway obstruction.
Obstruction may occur at any point within the airway, from the upper airways to the bronchi deep within the chest.
Common causes of airway obstruction
tongue (due to unconsciousness)
soft tissue swelling
Larynx (voice box)
- foreign material, direct injury, soft tissue swelling
- secretions, oedema, blood
- aspiration of gastric contents
Recognition of airway obstruction
LOOK for chest/abdominal movement
LISTEN at mouth and nose for breath sounds and abnormal noises
FEEL at mouth and nose for expired air
Abnormal sounds in airway obstruction
Snoring - due to obstruction of upper airway by the tongue
Gurgling - due to obstruction of upper airway by liquids (blood, vomit)
Wheezing - due to narrowing of the lower airways
Complete airway obstruction is silent.
Opening the airway
Remove crash helmet with manual in-line stabilisation of the c-spine
Head tilt (NOT if c-spine injury)
Chin lift with manual in-line stabilisation of the c-spine
Jaw thrust with manual in-line stabilisation of the c-spine
Suction with manual in-line stabilisation of the c-spine
- Will stimulate vomiting and movement in conscious or semi-conscious casualties
- This may result in;
worsening airway problems
cervical spine compromise
Sizing an oropharyngeal airway
Oropharyngeal airway insertion
Will cause bleeding from the nose in a large number of cases.
This will result in worsening airway problems so use only as a last resort.
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