Airway Obstruction (HB)

Airway Obstruction (HB)

Airway obstruction can take one of two forms: partial or complete. The tongue, foreign bodies, fluid, or swelling can be a cause of airway obstructions.

With a partially obstructed airway, the patient can still move some air. If the partial obstruction is prolonged, it can lead to respiratory failure. The patient may be coughing or gagging in an attempt to clear the object—this is a good sign because they can still move air—let them as long as it is productive. Coughing and patient involvement is the best way to fix the problem. The body knows how to expel blockages and is trying to correct the problem.

There is not much we can do about swelling. But we can attempt to manage foreign bodies and fluid. If the problem is fluid and can’t roll the patient over, we can use a suction device to remove what we can. Using a 60cc syringe and a nasal pharyngeal airway, we can form a field-expedient suction device. Insert it into the patient’s mouth along the side of the mouth (be careful not to push it into the back of the throat and trigger the gag reflex if the patient is conscious) and suck the obstruction out.

https://youtu.be/FwR3hh_IENo

If a patient has a complete obstruction from a foreign object, they will not move any air. In this case, we must provide mechanical assistance in the form of abdominal thrusts. Stand behind the patient in a way that you can support their weight if they go unconscious.

  • Wrap your arms around their midsection.
  • Form a fist with the thumb side pointing toward the patient.
  • Put the fist just above their belly button.
  • Cup that fist with the opposite hand.
  • Firmly and forcefully compress the patient’s abdomen.
  • Repeat until the object is expelled or the patient goes unconscious.
  • If the patient goes unconscious, gently lower them to the ground and reassess breathing—the object may have dislodged when the patient relaxed. If the patient is still not breathing, try to pass air. If you cannot pass air, reposition the head and try again. If you still cannot pass air, perform chest compressions as if you were doing CPR.