Lesson 1 – Introduction to Airway Management

Airway Management

A critical EMS skill focused on ensuring oxygen delivery to tissues. It is often the first step in resuscitation and essential in preventing deterioration in emergencies.

Respiratory Anatomy

The upper airway includes the nose, mouth, pharynx, and larynx. The lower airway includes the trachea, bronchi, bronchioles, and alveoli. The diaphragm is the main respiratory muscle, separating the chest from the abdomen. Obstruction at any level can cause respiratory distress.

Respiration and Gas Exchange

Inhalation occurs when the diaphragm and intercostals contract, creating negative pressure to draw in air. Air travels from nose/mouth → pharynx → trachea → bronchi → bronchioles → alveoli. In alveoli, oxygen diffuses into capillaries and carbon dioxide diffuses out. Exhalation is passive as muscles relax. This gas exchange sustains cellular function.

Adequate vs. Inadequate Breathing

Adequate breathing: 12–20 breaths/min (adults), normal depth and effort, clear sounds, good skin color. Inadequate breathing: abnormal rate, shallow/labored breathing, cyanosis, abnormal sounds (wheezing, gurgling). Quick recognition is vital for intervention.

Airway Compromise Causes

Common causes include: tongue obstruction in unconscious patients, foreign bodies (choking), trauma (swelling/bleeding), asthma, COPD, anaphylaxis, drowning. Identifying these helps guide immediate action.

Airway Assessment

Use Look (chest rise), Listen (breath sounds), Feel (air movement). Check for signs of increased effort (accessory muscles, nasal flaring). Use pulse oximetry for oxygen saturation. Capnography, if available, gives CO₂ and ventilation data.

Initial Airway Management Steps

Ensure scene safety → assess responsiveness → open airway (head-tilt chin-lift or jaw thrust if spinal injury suspected) → check breathing and pulse → begin intervention as needed. This systematic approach is essential.

Airway Positioning

Recovery position maintains airway in unconscious breathing patients. Sniffing position (ears aligned with sternal notch) optimizes alignment for airway procedures. Upright positioning can ease breathing in conscious patients. Choose based on condition and comfort.

Airway Management Summary

Success depends on understanding respiratory anatomy/physiology, recognizing inadequate breathing, and using initial assessments and positioning effectively. A structured approach saves lives. The next lesson covers Basic Airway Management Technique