NREMT Emergency Medical Technician (EMT) Cognitive ExamAirway, Respiration & VentilationHard
A 30-year-old male is found unconscious after a motor vehicle collision. He has obvious facial trauma and suspected cervical spine injury. His respirations are gurgling and shallow. What is the most appropriate initial airway management technique?
- AHead-tilt, chin-lift maneuver.
- BJaw-thrust maneuver.
- CNasopharyngeal airway (NPA) insertion.
- DOropharyngeal airway (OPA) insertion.
Show answer & explanationAnswer & explanation
Correct answer: B. Jaw-thrust maneuver.
Given the suspected cervical spine injury, a jaw-thrust maneuver is the preferred method to open the airway as it minimizes movement of the cervical spine. The gurgling respirations indicate fluid in the airway, which requires suctioning after the airway is opened, but opening the airway is the first step.
Why the other options are wrong
- A. Head-tilt, chin-lift is contraindicated with suspected spinal injury as it hyperextends the neck.
- C. NPA insertion is contraindicated with severe facial trauma, especially if basilar skull fracture is suspected, which is a risk with facial trauma from an MVC.
- D. OPA insertion is done after the airway is opened manually and if the patient is unresponsive with no gag reflex; it doesn't open the airway initially.
Jaw-Thrust Maneuver
A manual airway opening technique used for patients with suspected spinal injury, performed by lifting the angles of the mandible without tilting the head.
- Minimizes cervical spine movement.
- Often requires two rescuers for effective execution and airway maintenance.
- Indicated when head-tilt, chin-lift is contraindicated.
Memory trick: Trauma means no tilt, just thrust the jaw.