NREMT EMT 8: Psychomotor Skills Stations - Airway Management and Oxygenation, BVM, OPA/NPA, Suctioning, Supraglottic Airway, e.g., King LT, iGel

What This Is: Airway Management and Oxygenation

Airway management is a critical skill for EMTs and bystanders to ensure a person can breathe properly in an emergency. Imagine airway management like unclogging a blocked straw – if the airway is blocked, oxygen can't reach the lungs, and the person can't breathe. A blocked airway can happen due to injury, illness, or even a simple thing like a piece of food getting stuck.

Key Steps / Core Facts

• BVM (Bag-Valve-Mask): A device used to breathe for someone who can't breathe on their own. It's like a big, portable straw that helps push air into the lungs. (Use with a mask, at least 10 breaths per minute, 1-2 seconds per breath)
• OPA/NPA (Oral Pharyngeal Airway/Nasal Pharyngeal Airway): A tube inserted into the mouth or nose to keep the airway open. It's like a flexible, hollow stick that helps keep the airway clear. (Use with a BVM, check for correct placement)
• Suctioning: Removing secretions or debris from the airway using a suction device. It's like using a vacuum cleaner to clean up a mess. (Use with caution, avoid causing more damage)
• Supraglottic Airway (e.g., King LT, iGel): A device inserted into the airway above the vocal cords to keep it open. It's like a soft, inflatable plug that helps keep the airway clear. (Use with a BVM, check for correct placement)
• CPR Compression Depth: At least 2 inches – like pushing down a soda can. (Use with a rate of 100-120 compressions per minute)
• CPR Compression Rate: 100-120 compressions per minute – like tapping your foot to a fast beat. (Use with a depth of at least 2 inches)
• Oxygen Flow Rate: 10-15 liters per minute – like a gentle breeze on a summer day. (Use with a mask or BVM)
• Airway Obstruction: A blockage in the airway that can happen due to injury, illness, or other factors. It's like a big, invisible plug that blocks the airway. (Red flag: difficulty breathing, wheezing, or coughing)
• Respiratory Arrest: When a person stops breathing on their own. It's like a sudden, unexpected power outage that stops the airway from working. (Red flag: no breathing, no pulse, or abnormal breathing patterns)
• AVPU (Alert, Voice, Pain, Unresponsive): A mnemonic to assess a person's level of consciousness. It's like a simple, 4-step checklist to see if someone is awake and alert. (A – Alert, V – Voice, P – Pain, U – Unresponsive)
• OPQRSTI (Onset, Provocation, Quality, Region, Severity, Time, Insurance): A mnemonic to assess a person's symptoms. It's like a 7-step checklist to gather information about a person's condition. (O – Onset, P – Provocation, Q – Quality, R – Region, S – Severity, T – Time, I – Insurance)

What Laypeople Can Do

• If someone collapses, first check for danger (oncoming traffic, fire). Then shout and tap their shoulder to see if they respond.
• If someone is choking, encourage them to cough or try to dislodge the object with their fingers. If they can't cough, perform the Heimlich maneuver.
• If someone is having trouble breathing, try to keep them calm and comfortable. If they're unconscious, call 911 and start CPR if you're trained to do so.
• If you're with someone who's having a seizure, try to keep them safe and comfortable. Don't try to restrain them or put anything in their mouth.

Common Mistakes

• Mistake: Not using a BVM with an OPA/NPA. Fix: Always use a BVM with an OPA/NPA to ensure proper airway management.
• Mistake: Not checking for correct placement of an OPA/NPA. Fix: Always check for correct placement of an OPA/NPA before using a BVM.
• Mistake: Not using suctioning correctly. Fix: Use suctioning with caution and only when necessary to avoid causing more damage.

Quick Practice Scenarios

1. A person is unconscious and not breathing. What should you do first?

Call 911 and start CPR if you're trained to do so.

1. A person is choking and can't cough. What should you do first?

Perform the Heimlich maneuver.

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

Call 911 and start CPR if you're trained to do so.

Last-Minute Exam Cram

• Normal oxygen saturation: 95-100%
• Normal respiratory rate: 12-20 breaths per minute
• Normal pulse rate: 60-100 beats per minute
• Normal blood pressure: 90-120/60-80 mmHg
• BVM flow rate: 10-15 liters per minute
• CPR compression depth: at least 2 inches
• CPR compression rate: 100-120 compressions per minute
• AVPU mnemonic: Alert, Voice, Pain, Unresponsive
• OPQRSTI mnemonic: Onset, Provocation, Quality, Region, Severity, Time, Insurance
• Agonal breathing is NOT normal breathing – start CPR
• A person with a seizure should not be restrained or have anything put in their mouth