NREMT Emergency Medical Technician (EMT) Cognitive ExamAirway, Respiration & VentilationMedium
A 24-year-old male is found unresponsive, supine, and gurgling. After positioning him on his side, you note continued gurgling. Which of the following is the most appropriate next step in managing his airway?
- ASuction the airway.
- BPerform a head-tilt, chin-lift maneuver.
- CInsert an oropharyngeal airway (OPA).
- DAdminister high-flow oxygen via a non-rebreather mask.
Show answer & explanationAnswer & explanation
Correct answer: A. Suction the airway.
Gurgling sounds indicate the presence of liquid (blood, vomitus, or secretions) in the airway. The most appropriate immediate action to clear the airway and prevent aspiration is to suction the airway. This should be done before attempting to insert an airway adjunct or ventilate.
Why the other options are wrong
- B. A head-tilt, chin-lift maneuver opens the airway by lifting the tongue, but it does not remove fluids causing gurgling.
- C. An OPA should only be inserted after the airway is clear of secretions/fluids; inserting it with gurgling could push foreign material deeper.
- D. Administering oxygen is important, but clearing the airway of fluid takes priority to ensure oxygen can reach the lungs.
Airway Gurgling Management
Gurgling in the airway indicates the presence of fluid; the immediate intervention is to suction the airway to clear the obstruction.
- Gurgling = fluid in airway.
- Suctioning is primary intervention.
- Prevents aspiration and allows effective ventilation.
Memory trick: Sounds of trouble, clear the pipe, then air can flow.