|Maintaining an open airway is a critical
aspect of operational medicine. 6% of preventable battlefield deaths
following injury are due to airway obstruction related to facial trauma.
In the unconscious victim, the tongue can fall back against the back of
the throat, blocking air from moving into the trachea and lungs.
Frequently, simple positioning of the chin, neck, and head will relieve
this upper airway obstruction.
If positioning fails to immediately solve the problem, insert an
airway. There are two types:
- Oral Airway:
This hard plastic device fits through the mouth, over the
tongue and into the back of the throat. It will effectively keep the
tongue out of the way. It is not a good choice in the conscious
patient or semi-conscious patient because it frequently provokes the
gag reflex, which could result in vomiting and aspiration by the
victim. To insert the oral airway, use a tongue-blade or
tongue-blade-like-device to push the tongue to the side. Then insert
the oral airway. If no tongue-blade-like device is available, insert
the oral airway reversed (with the curve upward toward the roof of the
mouth. When half-way in, rotate the oral airway 180 degrees (so the
curve is now downward) and the airway will usually slide right into
- Naso-pharyngeal Airway:
This soft rubber (latex) airway passes through the nose,
straight back over the palate and into the back of the throat. It
usually doesn't cause a gag reflex, but may cause some nasal
irritation. It is best inserted after first lubricating the tip with
KY jelly or other similar lubricant. Then pass the airway gently but
firmly slightly up then over the palate until the flange is tight
against the nose.