Protecting and improving the airway

Protection of the airway can involve:

• insertion of an airway if appropriate. Choice airway depends on the level of consciousness of the patient:
  • patient with signs of airway obstruction but relatively conscious, try a nasopharangeal airway
  • patient with signs of airway obstruction and impaired level of consciousness, try an oropharangeal airway
  • unconscious and unable to protect their airway, needs a definitive airway ie. intubation and insertion of endotracheal tube
• for improving and protecting the airway:
  • if the airway is poor, for example if laryngeal swelling has occurred, i.e. due to smoke inhalation, then the decision to intubate may be made
  • intubation may similarly be performed early if laryngeal oedema appears likely to develop
  • attempts at intubation should be made for as long as the clinician can hold his or her own breath

Notes:

• people need to be less conscious to tolerate an oropharangeal airway; but if cannot tolerate an oropharangeal airway, may tolerate a nasopharangeal airway