First aid: Airway, choking and asphyxia
In the second part of our series, Samena Chaudhry and colleagues guide you through management and problems associated with airway obstruction
When a person has collapsed or is unconscious, they risk an obstruction of their airway. Airway compromise can be sudden and complete, insidious or partial, and progressive or recurrent. Inadequate delivery of oxygenated blood to the brain and other vital structures is the fastest killer of trauma patients.1 Hypoxaemia, inadequate oxygen supply in arterial blood, can be prevented by a protected unobstructed airway and adequate ventilation.
A man was in a motorcycle crash and has arrived in the emergency department. He was lying about 8 m from his bike and still has his full face helmet on. Upon initial assessment, you hear gurgling from his airway. The ambulance driver tells you that his respiratory rate is 7 breaths/min and irregular with a weak, rapid heart rate of 140 beats/min. He is unconscious. As you glance at his body for obvious bleeding, you note pinkish fluid draining from his nose.