All Emergencies - Basic life support principles:

  1. Maintain an airway
  2. Assess breathing
  3. Monitor circulation
Monitor and record all vital signs.
Airway Obstruction
Signs/symptoms: Gurgling or wheezing sounds, high-pitched crowing sound, increased difficulty in ventilation.




Adult - conscious victim:

  1. Ask: "Are you choking?"
  2. Heimlich maneuver until foreign body is expelled or victim becomes unconscious.


Adult - victim, known obstruction, lost consciousness:

  1. Activate EMS - 911 if second person is available
  2. Tongue-jaw lift
  3. Finger sweep to check for foreign body
  4. Attempt to ventilate
  5. If unable to ventilate, perform 6-10 abdominal thrusts
  6. Repeat items #3-5 until effective


Adult - victim, lost consciousness, cause unknown:

  1. Position patient supine, feet elevated
  2. Call for help of office emergency team
  3. A - Airway - head tilt, chin lift
  4. B - Assess breathing (look, listen & feel)
  5. Attempt to ventilate. If unsuccessful, proceed to step 6
  6. Activate EMS - 911
  7. Perform Heimlich maneuver - 6-10 abdominal thrusts
  8. Perform foreign body check - finger sweep
  9. Attempt to ventilate. If unsuccessful, repeat #7 & 8 until effective


Emesis and Aspiration of Foreign Material:

  1. Position patient into Trendelenburg position - head-down tilt of at least 15 degrees
  2. Call 911 - Activate EMS as soon as aspiration has been diagnosed.
  3. Suction the pharynx to remove any vomitus
  4. Secure the airway. Use airway device such as LT-D device as needed.
  5. Administer oxygen
  6. Administer IV steroids to minimize development of inflammation, edema & aspiration pneumonitis.
  7. Hospitalization is usually needed for a patient who aspirated.



Airway Management - i-gel training (USA)