1. Prepared by:
Aashish Parihar
m.sC. Nursing
Maintenanceofpatentairway

2. Maintenanceofpatentairway
Airways must remain free
from obstruction to enable
effective respiratory
function and thus sustain
life. Remember, if the
client has stopped breathing
instigate artificial
respirations immediately

3. Maintenanceofpatentairway
Airway management is the
medical process of ensuring
there is an open pathway
between a patient’s lungs and
the outside world, as well as
reducing the risk of aspiration.
Airway management is a primary
consideration
in cardiopulmonary
resuscitation, anesthesia, emer
gency medicine, intensive care
medicine and first aid

4. Maintenanceofpatentairway
Assessment of airway
Breathing pattern
Dyspnoea
Labored breathing
Breathing sound
Stridor
wheezing
Chest wall movement
Reverse movement of these, i.e. chest
sucked in and abdomen protruding
indicates an obstruction
Colour of skin
cyanosis

5. Maintenanceofpatentairway
Choking
unconsciousness
Panic

6. Maintenanceofpatentairway
Causes of airway obstruction
Foreign bodies
Aspiration of vomitus
Tracheolaryngeal trauma
Plugging of mucus
Diphtheria
Obstructive lung diseases
Tracheobronchitis

7. Maintenanceofpatentairway
Management
Removal of foreign bodies
Removal of vomit and regurgitation
Airway maneuvers
Invasive airway management

8. Maintenanceofpatentairway
Removal of foreign bodies
If you suspect an obstruction check
in the client’s mouth for any
obvious obstruction, e.g. vomit,
foreign body, etc. and remove
same by sweeping the mouth
with a finger. Great care should
be taken not to push any foreign
body further into the air passage
or
Perform abdominal thrusts also
known as Heimlich maneuver

9. Maintenanceofpatentairway
Removal of vomit and regurgitation
In the case of a patient who vomits or has other secretions
in the airway, these techniques will not be enough.
use suction to clean out the airway, although this may
not always be possible.
An unconscious patient who is regurgitating stomach
contents should be turned into the recovery
position when there is no suction equipment
available.
As this allows (to a certain extent) the drainage of fluids
out of the mouth instead of down the trachea.
The recovery position refers to one of a series of
variations on a lateral recumbent or three-quarters
prone position of the body, in to which
an unconscious but breathing casualty can be placed
as part of first aid treatment.

10. Maintenanceofpatentairway
AIRWAY MANEUVERS
Head-tilt chin-lift
Basic procedure used in
cardiopulmonary
resuscitation.
Rescuers one hand tilts
head back while other
hand is placed under the
chin to lift the mandible
and displace the tongue.

11. Maintenanceofpatentairway
AIRWAY MANEUVERS
Head-tilt chin-lift
 The head-tilt chin-lift is the primary maneuver
used in any patient in whom cervical spine injury
is not a concern.
 The simplest way of ensuring an open airway in an
unconscious patient.
 This is taught on most first aid courses as the
standard way of clearing an airway.

12. Maintenanceofpatentairway
AIRWAY MANEUVERS
Jaw-thrust maneuver
Index and middle fingers
are used to physically
push the posterior (back)
aspects of the mandible
upwards while their
thumbs push down on
the chin to open the
mouth.

13. Maintenanceofpatentairway
AIRWAY MANEUVERS
Jaw-thrust maneuver
 The jaw-thrust maneuver is an effective airway
technique.
 It is used in the patient in whom cervical spine
injury is suspected and is used on a supine patient.
 It prevents the fall of tongue thereby maintain the
patent airway.

14. Maintenanceofpatentairway
AIRWAY MANEUVERS
Cervical spine immobilization
Most airway maneuvers are associated with some movement of
the cervical spine (c-spine).
Even though collars for holding the head in-line can cause
problems maintaining an airway and maintaining a blood
pressure.
However, it is not recommended to remove the collar without
adequate personnel to manually hold the head in place.

15. Maintenanceofpatentairway
Invasive airway management
Oropharyngeal airway
Oropharyngeal airways (OPA) (also known
as Guedel airways) are rigid plastic
curved devices used to maintain an open
airway.
When a person becomes unconscious, the
muscles in their jaw relax and allow the
tongue to obstruct the airway.
An OPA should only be used in a deeply
unresponsive patient because in a
responsive patient they can cause
vomiting and aspiration.

16. Maintenanceofpatentairway
Invasive airway management
Nasopharyngeal airway
The nasopharyngeal airway (NPA) (also known
as a nasal trumpet) is a soft rubber or plastic
hollow tube that is passed through the nose
into the posterior pharynx.
It is used in the patient with jaw clenched or
semiconscious.
NPAs are generally not recommended if there is
suspicion of a fracture to the base of the
skull, due to the possibility of the tube
entering the cranium.

17. Maintenanceofpatentairway
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