The TCCC Guidelines outline the Committee on Tactical Combat Casualty Care (CoTCCC)-recommended approach to airway management. We will review the details of each step and intervention throughout the rest of this module and in the skills stations, but this provides a general overview of the strategy you should adopt in assessing and managing the airway during Tactical Field Care.

If the casualty is conscious and shows no signs of airway obstruction, then proceed to assessing their respiratory status (the “R” in MARCH PAWS).

If the casualty is unconscious (or nearly unconscious), but has no signs of obstruction, then the casualty can be placed in the recovery position, airway can be opened with a head-tilt/chin-lift or jaw-thrust maneuver.

However, if a semi-conscious casualty has an impending or current obstruction, they should be allowed to assume whatever position that best protects the airway, to include sitting up and/or leaning forward, after attempting airway maneuvers. If the casualty becomes unconscious during these interventions, then place them in the recovery position after.

If these actions establish an airway successfully, move to assessing their respiratory status. But if they are not successful, move to establishment of a more advanced airway by performing a cricothyroidotomy before moving on to the respiratory assessment.