Amid an emergency—especially one with the potential to compromise the airway—every second counts. But airway assessments cannot be rushed. An airway assessment becomes even more important in emergency scenarios because difficult airways, secondary complications, trauma, and infection are more likely. Here’s what you need to know to assess patient airways in emergency situations.
Rushing Doesn’t Improve Outcomes
It’s human nature to rush in an emergency, particularly if the patient is in obvious distress. Rushing will not improve the patient’s prognosis, but it will increase the risk of airway management complications. For example, choosing the wrong equipment or failing to assess for a difficult airway prior to intubation is known to increase the risk of airway trauma. Airway trauma can increase other risks, such as the threat of aspiration or infection.
A Systematic Approach Is Key
In the world of emergency medicine, surprise is the name of the game. Take a systematic approach to everything. If you focus solely on the airway, you may miss a more critical symptom. For example, a patient who seems to be choking may actually be in a state of anaphylaxis. Or consider the patient who suffers a traumatic pneumothorax incident. You might be able to stop the bleeding or remove an object obstructing the airway, but without addressing the lung, the patient will continue to decline. Take a few moments to examine the patient, assess their overall condition, look for recent injuries, and weigh the patient’s relative risk for various ailments.
You Must Assess for a Difficult Airway
Before intubating the patient, assessing for a difficult airway is critical. Many first responders fear difficult airways, and especially worry about the dreaded “can’t intubate, can’t oxygenate” (CICO) crisis. Assessments save lives and time because a slight change in strategy can overcome the challenges of a difficult airway. For example, you might need a smaller laryngoscope blade for a patient with an unusually short thyromental distance. In addition to assigning the patient a Mallampati score, look for obvious clues that the airway may be difficult, such as:
- The patient snores, or is snoring.
- The patient is obese.
- The patient has a broken jaw or physical airway trauma.
- The patient is a child or an elder.
- The patient has dementia or another serious mental health or cognitive ailment.
- The patient is uncooperative or panicking.
Perhaps most importantly, train regularly to master these scenarios. Managing a difficult airway is always more difficult in an emergency than it is in the classroom setting. Despite this, regular training sharpens your skills and makes it easy to overcome anxiety when moments count.
Choose the Right Equipment
The right equipment is a key ingredient in the recipe for successfully treating all airways, but especially difficult ones. Quality equipment also matters in challenging scenarios, such as when a patient is vomiting while aspirating. Your response kit must contain a variety of catheters, tubing, and similar airway equipment so that you can treat patients of all backgrounds, sizes, ages, and medical histories.
A portable suction machine empowers you to treat patients no matter where they are. Even if you work in a hospital setting, portable suction helps you meet your Emergency Medical Treatment and Active Labor Act (EMTALA) requirements. It also means you never have to delay treatment to move a patient. For help selecting the right machine for your agency or clinic, download our free e-book, The Ultimate Guide to Purchasing a Portable Emergency Suction Device.
