NREMT Emergency Medical Technician (EMT) Cognitive ExamAirway, Respiration & VentilationMedium
A 45-year-old male is found unconscious after a fall from a ladder. He has snoring respirations and obvious facial trauma. Which of the following airway maneuvers is most appropriate for this patient?
- AOropharyngeal airway insertion
- BJaw-thrust maneuver
- CNasopharyngeal airway insertion
- DHead-tilt, chin-lift
Show answer & explanationAnswer & explanation
Correct answer: B. Jaw-thrust maneuver
Snoring respirations indicate that the tongue is likely blocking the airway. In a trauma patient, especially one with a fall from a height and obvious facial trauma, a cervical spine injury must be assumed. Therefore, the head-tilt, chin-lift maneuver, which involves hyperextension of the neck, is contraindicated. The jaw-thrust maneuver opens the airway by displacing the mandible forward without extending the neck, making it the most appropriate choice to maintain cervical spine precautions.
Why the other options are wrong
- A. An OPA can be used after the airway is opened, but the primary maneuver to open the airway while maintaining C-spine precautions is the jaw-thrust. Facial trauma could also make OPA insertion difficult or increase risk of obstruction.
- C. A nasopharyngeal airway is contraindicated in patients with suspected facial trauma as it could enter the cranial vault if there are basilar skull fractures.
- D. The head-tilt, chin-lift maneuver is contraindicated in trauma patients with suspected cervical spine injury due to the risk of exacerbating the injury.
Jaw-Thrust Maneuver in Trauma
The jaw-thrust maneuver is the preferred method for opening the airway in trauma patients with suspected spinal injury, as it avoids neck hyperextension.
- Used when C-spine injury is suspected.
- Opens airway by displacing mandible.
- Minimizes neck movement.
Memory trick: Trauma = Thrust, No Tilt for the spine.