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. 

As a paramedic or EMT, your first responsibility in patient care is to secure a patent airway. Whether you are placing an EOA to elevate the tongue of an overdosed patient, suctioning the oropharynx of a trauma code, or inserting an endotracheal tube for a patient who has stopped breathing, a thorough understanding of the structures that make up the respiratory tract is a must. Here is a brief review of airway anatomy to ensure you're ready for the next respiratory emergency.

A number of things, including allergies, a minor cold, and the flu can all cause airway discomfort. And complications from these usually minor conditions can be dangerous, especially in vulnerable people such as elders 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. 

While tachycardia can be a sign of respiratory distress, it also can be a complication of interventions to treat respiratory distress, including suctioning. First responders and medical providers must have a clear understanding of the link between tachycardia and suctioning so that they can reduce the risk of patient injuries and improve both long- and short-term outcomes. 

Seizures are a common emergency. First responders frequently encounter febrile seizures in children, epileptic seizures, and seizures due to brain anomalies such as dementia or brain lesions. In most cases, the seizure itself is not dangerous, but the medical condition that caused it may be.

Precision and skill is required for Advanced airway management, especially in vulnerable patients. When performed correctly, initiating nasopharyngeal airways is very safe—and much safer than the alternative of doing nothing. Many first responders are reluctant to initiate a nasopharyngeal airway, citing fears of complications. But this route can enable intubation in patients with an intact gag reflex. Proper training can promote greater confidence, so don’t let fear deter you from practicing this life-saving technique. Forewarned is forearmed, so let’s look at some potential complications. 

Just weeks ago, it appeared that the COVID-19 in the U.S. may have been on the ropes. But the rise of the Delta variant and the potential for more variants to come reminded us that this dangerous virus will remain for the foreseeable future.

Have you ever been in a code situation where there were multiple failed intubation attempts on a patient? If so, you aren’t likely to forget it. Managing a difficult airway is one of the most challenging circumstances for even the most seasoned medical professional.