Basic airway management is a vital skill. Without basic airway management, a patient’s life will cease after roughly eight minutes, so it’s the most important part of any assessment. The first thing we’re going to do is actually make sure the head is in line and the airway is nice and clear. So one of the ways we use is a head tilt, chin lift, fingers onto the jaw bone, hand onto the forehead, roll the head back so it opens the airway. This tightens up the tongue, takes the tongue off the back of the throat and the airway now, if clear, should work appropriately. The next thing we are going to do is have a look inside the airway to see if we can see any fluid, blood, teeth or any foreign objects that need to be removed, and we will remove those at this point. Once that is done, if the airway still has any fluids or liquids, we would use suction or postural drainage to clear the airway. Postural drainage means turning the patient into the recovery position or turning them onto their side to allow the tongue to fall forward and fluids and liquids to drain clear, whether its blood or vomit. Suction, however, requires the use of a suction aid, whether it be an automatic suction unit or a manual suction unit, but the airway must be kept clear to work.
There are other methods to open an airway, one being the jaw thrust. This could be either a single person or a dual person operation. From behind, on a patient that is on the floor who has spinal injuries, we don’t want to tilt the head back because the neck may become damaged by the action of tilting the head. So what we’re going to do, is we’re going to get down to the patient’s level, lie on the floor and push the jaw forward, taking the tongue from the back of the throat. So, lying in a position where we can take control of the c-spine, we then insert the top two fingers into the arch of the jaw and we press forward. Pressing forward lifts the jaw forward, taking the tongue clear from the back of the airway. This should work quite nicely to clear the airway itself from its tongue obstruction. These are the two most common used airway clearance methods. Once the airway has been cleared, we then look, listen and feel for no more than 10 seconds to check that breathing is actually taking place. Breathing needs to be a regular rhythm between 12 and 20 breaths per minute.
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