Some EMS systems start with a simple airway adjunct and only move on to more invasive measures if the others are insufficient. EMS providers can create a standardized plan for airway management based on their protocols or medical director guidelines – it will be one less thing to think about on what could be a hectic and difficult call.
Fremont, CA: One of the first questions an EMS provider should ask about a patient who has suffered significant facial trauma is whether the patient has a patent airway and will be able to keep it open. Bleeding, broken teeth, soft tissue swelling, and other fractures can all obstruct the patient's airway.
In these patients, attention must be paid to how the airway is managed to balance managing the airway and potentially exacerbating other injuries.
Here are some steps to manage a difficult airway:
Efficient Airway Management Preparation
When treating a critical patient with a compromised airway, the last thing one wants to do is fumble around with ill-organized airway adjuncts. EMS providers can take the time to set up and store equipment in a logical manner to help ensure that time is not wasted on the scene looking for an adjunct or piece of equipment.
Agencies should preferably have a single layout for airway and other kits, but at the very least, supplies and equipment should be placed in the same basic area of dissimilar bags. Furthermore, collaboration with other local agencies can extend this standardization to an entire system, allowing responders from different agencies to be familiar with the majority – if not all – of the bags in a system.
Patient Assessment Plan
Over time, many EMS providers develop a flow to their calls. Providers will conduct assessments in the same manner, ask questions about a patient's medical history in the same order, and write the majority of their patient care reports in the same manner. This approach to medical practice helps to make sure that no steps are overlooked in airway management. By performing a task in the same order or in the same manner each time, providers can free up their time to focus on what makes a call different or unique.
Airway management can be approached in the same manner. EMS providers can create a flow for managing a patient's airway. After assessing a patient and determining that the airway is inadequately managed, they can begin with positioning, then suction if necessary, reexamine the patient's airway and breathing, and begin an intervention if either is inadequate.
Some EMS systems start with a simple airway adjunct and only move on to more invasive measures if the others are insufficient. EMS providers can create a standardized plan for airway management based on their protocols or medical director guidelines – it will be one less thing to think about on what could be a hectic and difficult call.
