Airway Management and Rescue Breathing
What the exam tests
This domain tests manual airway opening, suction, airway adjuncts, bag-valve-mask ventilation, and rescue breathing for adults, children, and infants.
Core rules
- Use head-tilt/chin-lift for a patient without suspected spinal injury. Use jaw thrust with spinal motion restriction when trauma is suspected.
- Remove visible obstructions only if seen; use suction for fluid or vomit. Do not perform blind finger sweeps.
- Oropharyngeal airways are for unresponsive patients without a gag reflex. Size from the corner of the mouth to the earlobe or angle of the jaw.
- Rescue breaths should produce visible chest rise and last about 1 second. Avoid excessive volume and rate.
- Bag-valve-mask ventilation is best with two rescuers: one seals the mask with both hands while the other squeezes the bag.
Worked example
An unresponsive worker has snoring respirations after a fall from a ladder. The first aider suspects spinal injury, uses a jaw thrust without head tilt, suctions vomit, and inserts an appropriately sized OPA after confirming no gag reflex. A second rescuer provides bag-valve-mask breaths at 10–12 per minute while spinal motion restriction is maintained.
Traps that cost marks
- Performing head-tilt/chin-lift on a patient with suspected cervical injury.
- Inserting an OPA in a patient who is conscious or has a gag reflex.
- Giving rapid, high-volume breaths that cause gastric inflation.
- Using a one-person BVM technique when a second rescuer is available.
Key points
- Head-tilt/chin-lift for routine airway opening; jaw thrust for suspected trauma.
- Suction fluids; never perform blind finger sweeps.
- OPA only for unresponsive patients without a gag reflex.
- Rescue breaths should produce visible chest rise.
- Two-person BVM ventilation improves mask seal and volume control.