Chapter 3: Respiratory System

Airway Problems

Protection of the airway - in the conscious subject the airway is protected by coughing. These is stimulated by the nerves sensing that there is an object in the air passage either in the nose, the mouth or lower down. The cough is propelled at 200 meters per second and this is forceful enough to expel any object within the airway. However, in the unconscious subject, there are two main hazards. One the cough reflex may be lost and if they are lying down the stomach contents can come back up the gullet and be inhaled. For this reason unconscious subjects are placed in what is called the "recovery position" (see Diagram 4a-d, page 36-38). This usually has them on their left side with their head down. This anticipates leakage from the stomach and this position will ensure that any stomach contents will leak down and away from the airway.

In the management of the unconscious subject the important aspects of their airway management are

1. to keep it open and ensure that it is clear and kept so. If any fluid is there an appropriate device removes it. The best way of protecting it is to have the subject in the recovery position with the head down, thus allowing any drainage to come away from the airway. The airway should be maintained (kept open).
2. They may obstruct their own airway with their tongue, there are manoeuvres (chin lift, jaw thrust) and airway aids which can maintain this for them (diagram 5, pages 38-47)