Compromised airway can result from three issues, namely obstruction, constriction, or trauma.
- Obstruction can happen through tongue positioning, foreign body, vomiting, or aspiration
- Constriction a.k.a. swelling can happen in the mouth, by the tongue, or due to airway structures
- Trauma can be either maxillo-facial (trauma to the jaw and face) or mandibular (trauma to the lower jaw)
Assessment for Compromised Airway
1. look
Watch out for accessory muscle use, tracheal tug, or paradoxical (see-saw) chest-abdo movements…
2. Listen
Can you hear any gurgling, stridor, snoring or hoarseness coming out of the casualty’s mouth?
3. feel
Can you feel air moving in and out of the casualty’s mouth or nose?
First Aid for Compromised Airway by Foreign Bodies
If a person coughs excessively whilst eating, keep a hands-off approach and encourage the person to cough. Coughing signifies that air is still going in and out of the lungs, thus, encourage to deep breathe and cough as hard as possible to cough out the obstructed foreign body.
If the person is not coughing, or coughing is ineffective, follow the 3 first aid maneuvers for compromised airway by foreign body listed below:
Back Blows
- give up to 5 back slaps – hit back from low direction upwards (least effective, least damaging)
Abdominal Thrusts
- perform up to 5 abdominal thrusts (moderately effective, moderately damaging – may cause organ rupture)
Chest Thrusts
- perform up to 5 chest thrusts (most affective, most damaging – casualty needs to be taken to hospital following chest thrusts to have internal organs checked due to possible damage)
NOTE: If obstruction doesn’t get cleared out, the casualty eventually collapses. At this point perform CPR and before giving mouth-to-mouth check inside the mouth to see if object has dislodged with compressions.
Paediatric Compromised Airway
- Babies usually deal with choking on their own, without needing first aid
- DO NOT perform abdominal thrusts on infants, since doing so may cause liver rupture. Instead, perform chest thrusts and back blows
Narcan (Naloxone)
Narcan (Naloxone) is a medication used to block the effects of opioids. It is commonly used in the case of decreased breathing triggered by opioid overdose such as in heroin overdose.
Naxolone may be combined with an opioid to decrease the risk of opioid misuse.
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