Clinical Skill Information Sheet

Basic Airway Management

Aim
To safely and effectively perform basic airway manoeuvres

Indications
Patients who are unable to effectively maintain a patent airway on their own, this will
usually be unconscious patients.
Background
When a patient is unconscious or semi-conscious they are unable to maintain their
own airway. This means that they are at risk of an airway obstruction, which will limit
airflow to their lungs. This will lead to hypoxia and ultimately death. Gaining and
maintaining a patent airway for all patients is a main priority for a paramedic and
forms a vital part of both the primary survey and the resuscitation process.

First aiders are taught to lay the patient in a lateral position, known as the recovery
position, so that the airway naturally opens. This is effective but it is difficult for a
paramedic to manage and transport a patient on their side. It is also not
recommended for a patient with suspected spinal injury.

Advanced airway management techniques and interventions are more easily

performed on a patient in a supine position (lying flat on back). Thorough inspection
of the airway can only be performed on a supine patient.

There are two main basic airway manoeuvres which are used in the pre-hospital
environment they are the Head Tilt – Chin Lift (a) and the Jaw Thrust (b).

(a) (b)

Bachelor of Paramedic Science - 2015


Objective Comments
Safety is the first priority
when managing any
patient.
Manage Airway management can
Safety provide a greater risk of
exposure to infectious
diseases due to the
proximity to airway
secretions.
The patient must be in a
position which will allow
the paramedic access to
clearly view the airway
once the manoeuvre has
been performed.
You may need to move an
object or the patient to gain
access to the patient’s
Prepare the airway.
patient
The paramedic must be
positioned appropriately to
ensure that the manoeuvre
can be maintained for an
extended period of time –
refer to the picture on the
right.
In order to get a clear view
of the upper airway, it is
important to move the
patient’s head in a way
which will displace the
tongue and ensure it does
not act as an obstruction.
Head Tilt –
Chin Lift
Bachelor of Paramedic Science - 2015
Clinical Skill Information Sheet
Action
1. Use universal precautions. Always
wear gloves and goggles when
attending to a patient.
2. You may also want to consider
wearing a face mask and gown.
1. Ensure the patient is supine. This
may require moving the patient. If
this is the case, ensure you maintain
cervical spine alignment if spinal
injury is suspected.
2. Ensure that there is enough space
behind the patient’s head for you to
sit/kneel/stand and work in.
3. Postion yourself behind the patient’s
head so that you can view their
entire body from head to toe.
1. Place one hand on the patient’s
forehead and gently tilt their head
back.
2. Place the fingertips of the other
hand under the point of the patient’s
chin and gently lift up to stretch the
anterior neck structures.
 Clinical Skill Information Sheet

In some circumstances it is 1. Use your fingers and place them

not appropriate to extend behind the patient’s jaw.
the patient’s neck to view
their airway, e.g. trauma. 2. Apply upward and forward pressure
to move the jaw.
In this instance a jaw thrust
must be performed. It can 3. Use your thumbs to press down
also be used as an gently on the chin. This will open the
alternative to the head tilt – mouth and give you a clearer view of
chin lift for any reason. the oropharynx.
Jaw Thrust It works to relieve
obstruction by the soft
palate and epiglottis by
bringing the mandible
forward.

Looking thoroughly inside 1. Get as close as necessary to fully

the oral cavity and as far
down the airway as
possible is necessary to
identify airway
Examine
obstructions.
oropharynx
You may need to get down
quite low to the ground in
order to visualise the
airway properly.
If an obstruction is
identified it is necessary to
clear it as quickly as
possible to maintain airway
Clear patency and avoid
oropharynx hypoxia.
(if required)
view the inside of the patient’s
mouth.
2. Move your own body as much as
necessary to view every angle inside
the mouth and upper airway.
1. If liquid is identified in the patient’s
mouth, tilt their head to the side to
allow gravity to drain it.
2. If the patient has a suspected spinal
injury, then ensure that you use a
log roll and other spinal precautions
to move the patient as tilting their
neck to the side in this way could
cause further injury.

Bachelor of Paramedic Science - 2015