Airway Management
1. Conscious casualty with no airway problem identified:
- No airway intervention required
2. Unconscious casualty without airway obstruction:
- Chin lift or jaw thrust maneuver or
- Nasopharyngeal airway or
- Extraglottic airway
- Place casualty in the recovery position
3. Casualty with airway obstruction or impending airway obstruction:
- Allow a conscious casualty to assume any position that best protects the airway, to include sitting up
- Use a chin lift or jaw thrust maneuver
- Use suction if available and appropriate
- Nasopharyngeal airway or
- Extraglottic airway (if the casualty is unconscious)
- Place an unconscious casualty in the recovery position.
4. If the previous measures are unsuccessful, perform a surgical cricothyroidotomy using one of the following:
- Cric-Key technique (Preferred option)
- Bougie-aided open surgical technique, using a flanged and cuffed airway cannula of less than 10 mm outer diameter, 6-7 mm internal diameter, and 5-8 cm of intratracheal length
- Standard open surgical technique using a flanged and cuffed airway cannula of less than 10 mm outer diameter, 6-7 mm internal diameter, and 5-8 cm of intra-tracheal length (Least desirable option)
- Use lidocaine if the casualty is conscious.
5. Cervical spine stabilization is not necessary for casualties who have sustained only penetrating trauma.
6. Monitor the hemoglobin oxygen saturation in casualties to help assess airway patency.
7. Always remember that the casualty’s airway status may change over time and requires frequent reassessment.