NREMT EMT 2: Primary Assessment - Assessing Airway Patency, Open, Maintainable, Obstructed

Assessing Airway Patency (Open, Maintainable, Obstructed)

Airway patency is the ability to breathe freely through the airway. Imagine a drinking straw – if it's blocked, nothing else works. In an emergency, assessing airway patency is crucial to save a person's life.

Key Steps / Core Facts

• Airway Assessment: Check if the person can breathe easily and speak clearly. If not, it may be obstructed. (OPQRSTI)
  • Why: Obstruction can lead to brain damage or death.
  • Example: A person who can only speak in short gasps may have an obstructed airway.
• Look for Obstruction: Check the mouth, nose, and throat for blockages like food, vomit, or blood.
  • Why: Obstructions can be life-threatening.
  • Example: A person who has choked on food may have an obstructed airway.
• Check for Spinal Injury: If the person has a neck or back injury, they may have an obstructed airway.
  • Why: Spinal injuries can cause paralysis or death.
  • Example: A person who has fallen from a height may have a spinal injury.
• CPR Compression Depth: At least 2 inches – like pushing down a soda can.
  • Why: Inadequate compression depth can lead to poor blood flow.
  • Example: A person who receives CPR with inadequate compression depth may not receive enough oxygen.
• CPR Rate: 100-120 compressions per minute – like a metronome.
  • Why: Inadequate rate can lead to poor blood flow.
  • Example: A person who receives CPR with an inadequate rate may not receive enough oxygen.
• Oxygen Saturation: Normal range is 95-100% – like a full tank of gas.
  • Why: Low oxygen saturation can lead to brain damage or death.
  • Example: A person who has a low oxygen saturation may need oxygen therapy.
• Respiratory Rate: Normal range is 12-20 breaths per minute – like a gentle breeze.
  • Why: Abnormal respiratory rate can indicate an obstructed airway.
  • Example: A person who has a respiratory rate of 40 breaths per minute may have an obstructed airway.
• Agonal Breathing: Irregular, gasping breaths – NOT normal breathing.
  • Why: Agonal breathing is a sign of cardiac arrest.
  • Example: A person who is agonal breathing may need CPR.
• Red Flags: Difficulty speaking, shortness of breath, or a history of respiratory problems.
  • Why: These symptoms can indicate an obstructed airway.
  • Example: A person who has a history of asthma may be more likely to have an obstructed airway.

What Laypeople Can Do

• If someone collapses, first check for danger (oncoming traffic, fire). Then shout and tap their shoulder.
• If the person is unresponsive, call 911 or your local emergency number.
• If the person is having trouble breathing, try to keep them upright and comfortable.
• If the person is choking, try to dislodge the object with the Heimlich maneuver (only if you are trained to do so).

Common Mistakes

• Mistake: Not checking for obstruction before starting CPR.
  • Fix: Always check for obstruction before starting CPR.
  • Why: Obstruction can lead to brain damage or death.
• Mistake: Not using a barrier device (like a mask) when giving CPR.
  • Fix: Always use a barrier device when giving CPR.
  • Why: Barrier devices can prevent the spread of diseases.
• Mistake: Not checking for spinal injury before moving the person.
  • Fix: Always check for spinal injury before moving the person.
  • Why: Spinal injuries can cause paralysis or death.

Quick Practice Scenarios

1. A person is found unresponsive on the floor. What should you do first?

Answer: Check for danger and shout/tap their shoulder. Reason: You need to ensure it's safe to approach the person and try to wake them up.

1. A person is having trouble breathing and is leaning forward. What should you do first?

Answer: Try to keep them upright and comfortable. Reason: This can help them breathe more easily.

1. A person is choking on food and is making a high-pitched sound. What should you do first?

Answer: Try to dislodge the object with the Heimlich maneuver (only if you are trained to do so). Reason: This can help dislodge the object and restore breathing.

Last-Minute Exam Cram

• Normal respiratory rate: 12-20 breaths per minute.
• Normal oxygen saturation: 95-100%.
• CPR compression depth: at least 2 inches.
• CPR rate: 100-120 compressions per minute.
• Agonal breathing is NOT normal breathing.
• Always check for obstruction before starting CPR.
• Always use a barrier device when giving CPR.
• Always check for spinal injury before moving the person.
• Normal body temperature: 98.6°F (37°C).
• Normal blood pressure: 90-120/60-80 mmHg.
• Normal heart rate: 60-100 beats per minute.
• Cardiac arrest is a medical emergency that requires immediate attention.