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 in mind these five tips can help you more effectively treat difficult airways.

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 this means 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:

Often when we think of the airway, we consider the entire respiratory system, forgetting that the upper and lower airway structures have different anatomies and, thus, are affected by different respiratory issues.

On January 2, people around the nation — be they football fans or not — were stunned by the live images from the Monday night football game, as the Buffalo Bills’ Damar Hamlin collapsed seconds after a tackle. Trainers soon began performing CPR, as it was later revealed the young player’s heart stopped twice on the field and he could not breathe without medical assistance.

There is perhaps nothing more terrifying to new parents than breathing problems in an infant. Particularly among newborns, respiratory distress is a common and potentially life-threatening symptom. Key differences in the airways of infants and children make them more susceptible to certain respiratory problems. A keen understanding of upper airway anatomy can help you quickly and safely treat infants in respiratory distress.

Airway management is a necessary intervention in many patient emergencies — from airway compromise to respiratory failure and cardiac arrest. However, depending on how severe the patient’s condition is, and the invasiveness of the intervention, airway management often causes negative effects to patients’ mental and physical health. 

Drug overdoses, sudden injuries, respiratory issues, and myriad other health concerns can trigger cardiac arrest. Cardiac arrest is a leading cause of death, but many of these deaths are preventable. Every year, more than 383,000 cardiac arrests occur outside of hospitals. Bystanders providing CPR immediately can double or triple the chance of survival. The figure is even higher when trained first responders are prepared to perform CPR while managing the airway. Airway management is key to successful CPR, and first responders must have the right equipment ready to go. 

Before the fall of 2022, most people were not thinking much about respiratory syncytial virus (RSV), even though most children get the illness by age 2, and even adults get the disease. But a remarkable surge of RSV cases, coupled with a heavy flu season and ongoing COVID-19 infections, is creating a trifecta of respiratory diseases that is wreaking havoc and pushing hospitals to the limit, and EMTs are seeing an uptick in calls concerning those facing serious symptoms.

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.