NREMT Emergency Medical Technician (EMT) Cognitive ExamAirway, Respiration & VentilationMedium
A 22-year-old female fell from a height of 15 feet and is now unconscious. She has clear fluid leaking from her nose and ears. Her respirations are rapid and shallow. What is the most appropriate method to open her airway?
- AInsert a nasopharyngeal airway (NPA).
- BInsert an oropharyngeal airway (OPA).
- CHead-tilt, chin-lift maneuver.
- DJaw-thrust maneuver.
Show answer & explanationAnswer & explanation
Correct answer: D. Jaw-thrust maneuver.
A fall from 15 feet makes a cervical spine injury highly probable. Clear fluid leaking from the nose and ears suggests a basilar skull fracture. In this scenario, the jaw-thrust maneuver is the safest way to open the airway as it minimizes neck movement. NPA insertion is contraindicated with suspected basilar skull fractures.
Why the other options are wrong
- A. NPA insertion is contraindicated with suspected basilar skull fractures (clear fluid from nose/ears) due to the risk of entering the cranial vault.
- B. OPA insertion is an adjunct used AFTER the airway is opened manually, and if the patient is unresponsive with no gag reflex.
- C. Head-tilt, chin-lift is contraindicated due to the high suspicion of cervical spine injury.
Airway Management in Head Trauma
Techniques used to establish and maintain an open airway in a patient with suspected head and/or spinal injury, prioritizing cervical spine protection.
- Jaw-thrust maneuver is the primary manual method.
- OPA can be used if no gag reflex.
- NPA is contraindicated with suspected basilar skull fracture (racoon eyes, battle signs, CSF leak).
Memory trick: Head trauma, jaw thrust, and no nose tubes!