MODULE 2:

AIRWAY

Chapter 6

Airway Care and

Rescue Breathing

Anatomy and Function of the

Respiratory System
All organisms need oxygen to stay alive.
The brain can only last 4 to 6 minutes
without oxygen.
Once brain cells are destroyed, they
cannot be replaced.
The respiratory system provides oxygen
and removes carbon dioxide from cells.

Upper Airways
Function
Protection
Humidification
Filtration
Structures
Nasopharynx
Oropharynx
Tongue
Epiglottis
Larynx

Lower Airways
Function
Filtration
Transmission of air
Structures
Trachea
Mainstem bronchi
Bronchioles
Terminal bronchioles

Structural Considerations

Trachea & bronchi: Cshaped cartilage

(posterior open)
Potential for airway
obstruction

Structural Considerations
Cilia: beat 100
times/second
MAST cells
secrete sticky
substance filled
with WBCs

Airway
Check for responsiveness.
Correct blocked airway.
Check for fluids, foreign bodies, or
dentures.
Correct airway using finger sweeps or
suction.
Maintain airway.

Correcting the Blocked Airway

Head tiltchin lift
technique

Jaw-thrust
technique

Finger Sweeps
1. Turn patient on side.
2. Insert your finger into
patients mouth.
3. Curve your finger into a
C-shape and sweep
from one side of back
of mouth to other.

Suctioning
Remove any large pieces with gloved
hand.
Suction only as deep as you can see.
Do not suction longer than:
15 seconds at a time for an adult
10 seconds at a time for a child
5 seconds at a time for an infant

Maintain the Airway

Maintain patients airway using one of
the following:
Recovery position
Oral airways
Nasal airways

Recovery Position

Oral Airways
Used to maintain patients
airway.
May only be used on
patients without a gag
reflex.
Functions as a pathway
to suction patient.
It is important to select
the proper size airway.

Skill Drill: Inserting an Oral Airway

1. Select the proper
size airway.
2. Open patients
mouth.
3. Insert airway upside
down along roof of mouth.
4. Rotate airway 180 degrees
into position.

Nasal Airways
Can be used on conscious or
unconscious patients.
Should not be used on
patients with head injuries.
Select proper size airway
prior to insertion.
Lubricate nasal airway prior
to use.

Skill Drill:
Inserting a Nasal Airway
1. Coat airway with
water-soluble
lubricant.
2. Select larger
nostril.
3. Insert airway until flange
rests against nose.

Signs of Adequate Breathing vs.

Inadequate Breathing

Adequate:
Rise and fall of chest
Sounds of air passing
into/out of patients
nose/mouth
Air coming out of
nose/mouth

Inadequate:
Noisy respirations,
wheezing, or
gurgling
Rapid or gasping
respirations
Pale or bluish skin
Respiratory arrest

Correct Breathing
Rescue breathing can be performed via:
Mouth-to-mask rescue breathing
Mouth-to-barrier rescue breathing
Mouth-to-mouth rescue breathing

Skill Drill:
Mouth-to-Mask Rescue Breathing
1. Open airway using head tiltchin lift
technique.
2. Or, open airway using jaw-thrust
technique.
3. Seal mask against patients face.
4. Breathe through mouthpiece.

Foreign Body Airway

Obstruction
Causes of airway obstruction
Tongue
Foreign body
Types of airway obstruction
Partial obstruction
Complete obstruction

Removing a Foreign Body Airway

Obstruction
Look for signs of
choking.
Locate xiphoid process
and navel.
Apply abdominal
thrusts.

Conscious Adult FBA

Obstruction
Ask Are you choking?
Give abdominal thrusts
up to 5
( chest
thrusts for pregnant or
obese victim)
Repeat thrusts until
effective or victim
becomes unconscious.

Unconscious Adult FBA

Obstruction
1.
2.
3.
4.

Establish unresponsiveness.
Active the EMS system
Open airway
Check breathing (look, listen,
feel ),if no breathing try to ventilate.
If obstructed, reposition head and
try to ventilate again

 5. Give up to 5 abdominal thrusts

6. Perform a tongue- jaw lift followed by a
finger sweep for visualized FB only
7. try to ventilate; if still obstructed,
reposition the head and try to ventilate
again
8. Repeat steps 5 through 7 until effective

Abdominal Thrust on an
Unconscious Patient
Place one hand above
navel and below
xiphoid process and
other hand on top of
your first hand.
Thrust inward and slightly upward.

Infants and Children

Do not attempt a blind finger sweep on an
infant or child.
Check the mouth for object first.
For infants, perform 5 back blows and 5
chest thrusts instead of abdominal thrusts.
Do not tilt infants head back too far.

Special Considerations

Patients with stomas

Gastric distention
Dental appliances
Airway management in a vehicle