Airway management involves making sure a person has a clear pathway to get air into his lungs. It also means ensuring a person has the ability to cough and swallow, which protects the airway from aspiration. Airway management is a crucial component of medical treatment during cardiopulmonary resuscitation (CPR). It may involve techniques to open the airway, insertion of a breathing tube, or use of other airway devices.
One of the most important steps in emergency medicine is making sure the patient has a clear airway. An initial assessment is the first step in airway management. Assessing the airway involves listening for breath sounds, counting the respiratory rate, and watching for chest rise.
In some cases, the patient may have an obstructed airway from either his tongue or a foreign object. Part of airway management is opening the airway by tilting the chin up or doing a jaw thrust. Both techniques help prevent the tongue from blocking the airway.
Various medical devices may be used to assist with managing the airway. The purpose of the devices is to maintain an open airway, so oxygen can get into the lungs. For instance, a nasopharyngeal airway is a tube that is inserted into the nose to keep the airway open. Another device used in airway management is an oropharyngeal airway. The device is inserted into the mouth and helps prevent the tongue from blocking the airway.
Other devices used in airway management may be needed to help provide ventilation assistance to patients who are not breathing on their own. The devices also may prevent a person from aspirating vomit or blood into his lungs. If a person is not breathing or cannot protect his airway, a tracheal intubation may be needed.
A tracheal intubation procedure involves inserting an endotracheal tube in the airway, usually though the mouth. This ensures there is an unobstructed path for oxygen and the airway is open. An endotracheal tube may allow for assisted ventilation or breathing for the patient with the use of a bag valve mask. It is also used if a patient will need to be connected to a ventilator to assist with breathing.
In order to provide airway management for patients who have severe facial trauma, a breathing tube may need to be inserted directly into the trachea through the front of the neck. This is referred to as a tracheotomy. Insertion of either type of breathing tube also allows medical personnel to clear the airway of mucus by suctioning it out with a suction catheter. This helps the airway remain clear.