The patient has suffered a gunshot wound to the chest, and his blood pressure is dangerously low. You’ve covered the entry wound to prevent a sucking wound, but the patient is exhaling copious bloody froth. You successfully intubate the patient and are bagging, with good chest rise, but the bloody froth continues to interfere with air exchange. It’s time to suction the tube.  

 Every patient is unique, and expert airway management demands a critical, creative, adaptive approach. However, first responders should follow established protocols and guidelines to get the best results. A simple algorithm can help guide decision-making in airway management while still allowing room for flexible problem-solving. Follow these guidelines to speed up treatment and reduce errors if you encounter a difficult airway: 

Many unexpected symptoms can stem from common traumas and accidents, and individuals often suffer significant airway damage from traumatic events. Around the world, injuries such as car accidents, gunshot wounds, and concussions account for more than 3 million non-fatal injuries annually. These common trauma scenarios can happen to anyone. 

 You are about to head out on a call for a 65-year-old man who is reported to be suffering from sudden respiratory distress. Few details are known about this man’s medical history, so you aren’t entirely sure what you are about to encounter. You grab your First In bag, knowing that your airway management tools mean you’re well–prepared for any airway emergency. 

 Sooner or later, every first responder encounters a difficult airway. Training for these scenarios is critical for improving patient care and reducing first responder frustration and burnout. There’s no substitute for lived experience, critical feedback from experienced providers, and drills that mimic real-world situations. And keeping these five tips in mind can help you more effectively treat difficult airways. 

Allergies, a minor cold, and the flu can all cause airway discomfort. Complications from these usually minor conditions can be dangerous, especially in vulnerable people such as the elderly and children. Also, serious conditions such as aspiration, partial obstructions, pneumonia, and other disorders may also trigger airway discomfort. As a first responder, it’s important to know when airway discomfort is a sign of a serious problem or just a passing symptom.

Users of battery-powered portable suction devices often comment that it “sucks”. This can be interpreted in two ways: either negatively or positively. When the negative sentiment applies, there’s no need to despair or throw the unit across the room.

As an EMS provider, you know traumatic injury plays a central role in many emergencies. Trauma calls make up a large percentage of responses and take a tremendous toll on lives throughout our country. Here are a few stark statistics from the National Trauma Institute:

The most critical treatment you provide is airway management. Whether intubating the patient in cardiac arrest, dislodging an obstruction, or simply assisting respirations, the speed and effectiveness of your treatment as a paramedic can mean the difference between life and death for your patients. So, let’s review three critical airway management steps you can’t afford to miss: assessment, equipment, and intervention.

Respiratory emergencies come in many forms. It could be an asthmatic who has suffered since childhood, a COPD patient who still smokes a pack a day, or a near-drowning who was pulled from the deep end of the pool. Whatever the crisis, as an emergency responder, you are called on to treat it.