NREMT EMT 4: Patient Treatment and Transport - Airway Management, Head Tilt-Chin Lift, Jaw Thrust, Oropharyngeal Airways, OPA, Nasopharyngeal Airways, NPA, Suctioning

What This Is: Airway Management

Airway management is the process of keeping a person's airway open to breathe. Imagine a drinking straw – if it's blocked, nothing else works. In an emergency, a blocked airway can be life-threatening. A person's airway can become blocked due to injury, illness, or other factors, making it difficult to breathe.

Key Steps / Core Facts:

• Head Tilt-Chin Lift: Gently tilt the person's head back and lift their chin to open the airway. (AVPU: Alert, Verbal, Pain, Unresponsive)
  • Why: To keep the airway open and allow breathing.
  • Example: A 5-year-old child who has fallen and hit their head.
• Jaw Thrust: Gently push the person's jaw forward to open the airway. (OPQRSTI: Onset, Provocation, Quality, Region, Severity, Time, Involvement)
  • Why: To keep the airway open and allow breathing, especially in cases of severe head or neck trauma.
  • Example: A 30-year-old man who has been in a car accident.
• Oropharyngeal Airway (OPA): A tube inserted into the mouth to keep the airway open.
  • Why: To keep the airway open and allow breathing, especially in cases of unconsciousness or severe head trauma.
  • Example: A 70-year-old woman who has fallen and hit her head.
• Nasopharyngeal Airway (NPA): A tube inserted into the nose to keep the airway open.
  • Why: To keep the airway open and allow breathing, especially in cases of severe head or neck trauma.
  • Example: A 40-year-old man who has been in a car accident.
• Suctioning: Removing secretions from the airway to keep it open.
  • Why: To keep the airway open and allow breathing.
  • Example: A 2-year-old child who has been vomiting.
• CPR Compression Depth: At least 2 inches – like pushing down a soda can.
  • Why: To ensure effective chest compressions.
  • Example: A 50-year-old man who has had a heart attack.
• CPR Compression Rate: 100-120 compressions per minute – like a metronome.
  • Why: To ensure effective chest compressions.
  • Example: A 25-year-old woman who has had a heart attack.
• Airway Obstruction: A blockage in the airway that can be caused by food, vomit, or other objects.
  • Why: To identify and remove the obstruction.
  • Example: A 10-year-old child who has swallowed a coin.

What Laypeople Can Do:

• If someone collapses, first check for danger (oncoming traffic, fire). Then shout and tap their shoulder.
• If someone is choking, encourage them to cough or perform the Heimlich maneuver.
• If someone is unconscious, call 911 and start CPR if trained.
• If someone is having trouble breathing, try to keep them calm and comfortable.
• If someone is vomiting, turn them on their side to prevent aspiration.

Common Mistakes:

• Mistake: Not checking for danger before approaching a collapsed person.
  • Fix: Always check for danger before approaching a collapsed person.
• Mistake: Not calling 911 in an emergency.
  • Fix: Always call 911 in an emergency.
• Mistake: Not starting CPR in a cardiac arrest.
  • Fix: Always start CPR in a cardiac arrest if trained.
• Mistake: Not keeping the airway open in a choking person.
  • Fix: Always try to keep the airway open in a choking person.
• Mistake: Not turning a vomiting person on their side.
  • Fix: Always turn a vomiting person on their side to prevent aspiration.

Quick Practice Scenarios:

1. A 60-year-old woman collapses in a store. What should you do first?

Answer: Check for danger and call 911. Reason: To ensure the person's safety and get medical help.

1. A 5-year-old child is choking on a piece of candy. What should you do first?

Answer: Encourage the child to cough or perform the Heimlich maneuver. Reason: To try to dislodge the object and keep the airway open.

1. A 30-year-old man is unconscious after a car accident. What should you do first?

Answer: Start CPR if trained. Reason: To try to keep the person's heart beating and brain functioning.

Last-Minute Exam Cram:

• Normal breathing rate: 12-20 breaths per minute.
• Normal heart rate: 60-100 beats per minute.
• Normal blood pressure: 90-120/60-80 mmHg.
• CPR compression depth: at least 2 inches.
• CPR compression rate: 100-120 compressions per minute.
• Agonal breathing is NOT normal breathing – start CPR.
• Always check for danger before approaching a collapsed person.
• Always call 911 in an emergency.
• Always start CPR in a cardiac arrest if trained.
• Always try to keep the airway open in a choking person.
• Always turn a vomiting person on their side to prevent aspiration.