Airway management means keeping the path for air open and making sure the patient is oxygenated and ventilated. It moves step by step from simple positioning and suction to airway devices, bag-valve-mask ventilation and advanced airways when needed.
Key symptoms
- Snoring or gurgling sounds
- Stridor, hoarse voice or trouble swallowing saliva
- Shortness of breath, cyanosis or low saturation
- Reduced level of consciousness
What you find on exam
- Look, listen and feel for air movement and chest rise
- Check the mouth for blood, vomit, teeth or foreign bodies
- Breathing rate, depth and oxygen saturation
- Predict a difficult airway: short neck, obesity, facial trauma, limited mouth opening
- Neck injury risk, which calls for jaw thrust instead of head tilt
Tests
- Pulse oximetry
- Waveform capnography to check ventilation and confirm tube placement
- Breath sounds and chest rise after each airway step
Treatment basics
- Head tilt with chin lift, or jaw thrust if spinal injury is possible
- Suction, then an oral or nasal airway
- Bag-valve-mask ventilation with oxygen, two-person technique when possible
- Supraglottic airway or endotracheal intubation after preoxygenation
- Confirm placement with waveform capnography and recheck after every move
Red flags
- Saturation falling despite ventilation
- No capnography waveform after intubation (tube not in the trachea)
- Stridor, airway burns or swelling that can close the airway
Practice it in Making Synapses
Making Synapses cases
Related guides
Sources: NASEMSO National Model EMS Clinical Guidelines; National EMS Education Standards (2021); NREMT psychomotor skill sheets (EMT and Paramedic). Written by Making Synapses. Making Synapses is not affiliated with these organizations.