Airway Management, Adjuncts and the Choking Patient Flashcards Preview

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Flashcards in Airway Management, Adjuncts and the Choking Patient Deck (43)
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'Initial Examination of Airway' - steps

Response - AVPU
Look for and remove obvious obstructions
Aspirate if necessary
Ensure patient airway


what are the 'Signs of normal breathing'

Even, bilateral rise and fall of the chest

Sound of air entering and leaving the nose and/or mouth

Feeling of air movement on your cheek

Normal skin colouration

Rate and depth of breathing adequate to sustain life


(Upper airway obstruction) Foreign body airway obstruction (FBAO) - cause

Tongue - most common cause in an unconscious patient

Foreign bodies - most common cause in a conscious patient: Blood, Saliva, Vomit, Displaced dentures, Food, Chewing gum, Extraneous small objects


Lower airway obstruction - cause

Excessive bronchial secretions

Pulmonary haemorrhage

Aspiration of regurgitated gastric contents


Partial Airway Obstruction - signs

Their is usually reduced air movement, the noise produced depends upon the nature and site.

Upper airway is more noticeable during inhalation whilst an obstruction of the lower airway is usually more apparent during exhalation.


Other airway noises: Gurgling

May indicate liquid or semi-solid material in the airway


Other airway noises: Snoring

May indicate a partial occlusion by the tongue


Other airway noises: Complete obstruction

No air movement will be heard or felt. But there may still be abdominal and chest movement


opening airway: head tilt/ chin lift

brings the tongue forward and upwards and so ensuring an open airway.


opening airway: Triple airway manoeuvre

Similar to jaw thrust manoeuvre except you maintain traction of the head using the heels of your hands


opening airway: Jaw thrust

For trauma patients.
Hold mouth open by downward movement of the chin with thumbs.
Using index fingers apply steady pressure upwards and forwards at the angles of the jaw to lift it.


Finger sweep

Open and inspect the mouth, carefully sweep two fingers from the side to the back, and hook out any foreign matter found, remove also any loose or broken dentures ONLY when clearly visible and very near to the lips.



Remove any blood/liquids/light solids by aspirating with appropriate catheter.


Mild airway obstruction

in response to "are you choking?"
patient answers "yes"
other signs - can speak, cough, breathe


Severe airway obstruction

in response to "are you choking?"
patient is unable to speak and may respond by nodding.
other signs - Unable to breathe, wheezy, attempts at coughing are silent, may be unconscious.


universal sign of choking

clutching the neck


management for: Mild airway obstruction - Adults

Encourage to cough and do nothing else.
Monitor carefully
Rapid transport to hospital


management for: Severe airway obstruction - Adults

Back Blows
Abdominal Thrusts


How to do: Back Blows

Stand to the side and slightly behind.
Support the chest (hold shoulder) and with one hand lean the patient forwards.
Give up to five sharp back blows between the scapulae.


How to do: Abdominal Thrusts

Stand behind the patient and place both arms around the upper part of the abdomen, clench your fist and grasp with the other hand.

Pull sharply & upwards with the aim of producing sudden expulsion of air and foreign body form the airway.


Airway obstruction: adult unconscious

if a patient is or becomes unconscious begin basic life support.

During CPR check the mouth for any foreign body that has been partly expelled.


Airway obstruction: children and infants.
Suspect that a child may be choking if there is:

Sudden respiratory compromise with associated coughing, gagging or stridor (creaking or grating noise).

No other signs of illness.

Other clues - eating, playing with small toys immediately prior

DO NOT PERFORM BLIND FINGER SWEEPS. airway obstruction may also occur with acute epiglottis or croup


General signs of airway obstruction:

witnessed episode
coughing or choking
sudden onset
recent history of playing with, or eating, small objects


Signs of ineffective cough

unable to vocalise
quiet or silent cough
unable to breath
decreasing level of consciousness


Signs of effective cough

Crying or verbal response to questions
loud cough
able to breath before coughing
fully responsive


Airway obstruction: back blows for infant and child

Position in the prone position with the head lower then the chest.

Deliver up to 5 back blows to the middle of the back between the scapulae.

With an infant hold them across your forearm and a child across your thigh whilst sitting.


Airway obstruction: chest thrusts for infant or child

Turn the child into a supine position again with head lower than the chest and the airway in an open position.

Give up to five chest thrusts to the sternum - the technique for chest thrusts is similar to that for chest compression.

Chest thrusts should be sharper and more vigorous than compressions and carried out at a rate.



foreign body airway obstruction


FBAO child - effective coughing

encourage to cough. do nothing else
monitor continuously
rapid transport to hospital


FBAO child - ineffective coughing or cough becomes ineffective

Summon help if appropriate.
Determine child's conscious level

IF CONSCIOUS: give back blows. if they do not relieve FBAO chest thrusts for infants. abdo thrusts for children

alternate until obstruction is relieved or patient loses consciousness.