Foreign Body Airway Obstruction (QAS)

FBAO

Foreign Body Airway Obstruction.

Types of airway obstruction in FBAO

Partial (mild or severe) and complete obstruction.

Mild obstruction

Patient can cough effectively, speak or cry, and maintain adequate air exchange.

Signs of severe / complete obstruction

Ineffective or absent cough, inability to vocalise, silent chest, cyanosis, decreasing consciousness.

QAS manoeuvres for conscious patient with severe FBAO

Up to 5 back blows, then up to 5 chest thrusts, alternate as needed.

Abdominal thrusts (Heimlich) in FBAO

No — abdominal thrusts are not recommended due to risk of harm.

Action when patient becomes unconscious in FBAO

Begin CPR and during chest compressions attempt direct laryngoscopy and removal (if visible) with Magill forceps.

Use of Magill forceps in FBAO

In an unconscious/obtunded patient if the foreign body is visible in the pharynx under laryngoscopy.

Important to avoid when removing with forceps

Avoid grasping pharyngeal tissues (uvula, epiglottis) and avoid blind sweeping that may worsen obstruction.

Action after relief of obstruction if spontaneous breathing does not resume

Manage airway with adjuncts (e.g. SAD, endotracheal tube), provide oxygen, transport and pre-notify hospital.