Basic Airway Management

Effective airway management is an essential component in the management of an unconscious breathing casualty.If an unconscious person is lying on their back, there are several airway hazards.

Blockage by tongue

When an unconscious person is lying on their back, gravity allows the jaw to drop backwards and permits the tongue to block the airway. The airway will also be blocked if the head of an unconscious person falls forward while sitting upright, as may happen in car accidents.

Loss of cough, swallow reflexes

We all continually swallow, whether consciously or unconsciously. For example, while you are reading this paragraph, your mouth is regularly filling with saliva that you swallow. After a meal, you may have regurgitation (gastric reflux), and you immediately swallow to avoid stomach contents entering your airway. A deeply unconscious person may lose their ability to cough and swallow to clear their airway.

Vomiting

Vomiting is an active and noisy process, during which muscular action causes the stomach to eject its contents and potentially block the airway. If inhaled, vomit can damage lung tissue. Should this occur, immediately turn the person onto their side into a recovery position to clear.

Regurgitation

Regurgitation occurs in an unconscious person when the muscle at the top of the stomach relaxes, allowing a slow, silent, passive flow of stomach contents to enter the airway which is then inhaled into the lungs. All too often it goes unrecognised until too late. Therefore, an unconscious person must be placed onto their side to protect their airway.

Clearing the airway

Before opening the airway, check for foreign material to reduce the risk of it flowing into the lungs.

Check and remove any visible material from the person's mouth using your fingers, and if necessary, place them on their side into a recovery position to assist clearance.

Remove any loose dentures.

Turn the face slightly downward to allow any fluids to drain from the mouth.

Recovery Position

If a person is unconscious, has a clear airway and is breathing normally, place them onto their side in a recovery position.

A recovery position will:

• maintain a clear airway
• facilitate drainage
• reduce the risks of inhaling foreign material.