Airway

Airway management is everything we do to keep our patients' airways clear, protected, and open so oxygen can move in and out of the lungs effectively.

We generally prioritise airways because we follow XABCDE, or in some cases, if there is no bleeding ABCDE. Airway (A) always comes first or second, but why? This is because without oxygen (clear airway), the brain can get damaged within 4-6 minutes; having a blocked airway can cause your patient to deteriorate rapidly, and because many of our emergency patients can't maintain/protect their own airway so we do it for them.

We also manage airways to prevent hypoxia (low O2 levels), prevent any aspiration from entering the lungs, and most importantly, buy our patient time until definitive care is available (hospital).

To keep your patient’s airway open without invasive techniques, you can perform the Head-tilt chin-lift, which, as the name suggests, involves lifting the chin while tilting the head to open the airway.

Another non-invasive way would be jaw thrusts, which involves moving the mandible forward without neck movement.

This is typically used when spinal injury or trauma is suspected.

Advanced airway management:

Note: GCS ≤ 8 – Intubate

One advanced way we are authorised to use is Endotracheal Intubation (ETI).

We intubate patients when they physically cannot hold an open airway (generally if GCS ≤ 8).

Intubation is by far the best airway protection from aspiration.

ETI allows for precise ventilation and is very suitable for long transportation.

A risk of intubation is that it can interrupt CPR if it is not well performed.