- Initial assessment*
- Assess responsiveness, airway patency, breathing, and circulation
- Look, listen, and feel for signs of obstruction or inadequate ventilation
- Airway opening manoeuvres
- Head tilt–chin lift (if no suspicion of cervical spine injury):
- Place one hand on forehead and tilt head back
- Use fingertips under the chin to lift it upward
- Opens the oropharynx by extending the neck and moving the tongue off the posterior pharynx
- Jaw thrust (if cervical spine injury suspected):
- Place hands on either side of the patient’s head
- Use fingers to lift the angles of the mandible upward
- Moves tongue and soft tissues anteriorly without neck movement
- Clearing the airway
- Remove any visible foreign bodies or vomitus
- Use suction if needed to clear secretions or blood
- Basic airway adjuncts
- Oropharyngeal airway (OPA):
- Used in unconscious patients without gag reflex
- Measure from the corner of the mouth to the angle of the mandible
- Insert upside down, then rotate 180° when in the mouth
- Prevents tongue from occluding the airway
- Nasopharyngeal airway (NPA):
- Can be used in semi-conscious patients with intact gag reflex
- Measure from nostril to earlobe
- Lubricate and insert into the nostril gently
- Avoid if basal skull fracture suspected
- Ventilation support
- Bag-valve-mask (BVM) ventilation:
- Ensure good mask seal (C–E grip)
- Squeeze bag to deliver breaths (~1 breath every 5–6 seconds)
- Use two-person technique if available: one maintains seal and airway, the other squeezes the bag
- Monitor chest rise and oxygen saturation
- Supplemental oxygen
- Nasal cannula (low flow) or non-rebreather mask (high flow)
- Add to BVM system to deliver high-concentration oxygen