How should you maintain a patent airway in a combative patient?

How should you maintain a patent airway in a combative patient?

• A. Ensure safety, attempt noninvasive airway adjuncts when possible, and escalate to ALS if necessary.
• B. Restrain immediately and avoid airway devices.
• C. Place an advanced airway before assessing safety.
• D. Do nothing and wait for calm.

Answer: (A)

Maintaining a patent airway in a combative patient starts with scene safety. Your first duty is to keep yourself and others safe, because you won’t be able to manage the airway effectively if the situation is out of control. Once the scene is secure, use noninvasive airway supports whenever possible to keep the airway open. This can include suctioning to clear secretions and employing airway adjuncts that can be used quickly with minimal restraint—such as an oropharyngeal airway if the patient is unconscious or has a reduced level of consciousness, or a nasopharyngeal airway if there’s no suspected skull fracture and the patient tolerates it. If airway patency remains in doubt despite these measures, call for and involve ALS for definitive, advanced airway management. Invasive airway procedures should not be attempted before safety is assured, and waiting for calm is not appropriate when the airway is at risk.

Maintaining a patent airway in a combative patient starts with scene safety. Your first duty is to keep yourself and others safe, because you won’t be able to manage the airway effectively if the situation is out of control. Once the scene is secure, use noninvasive airway supports whenever possible to keep the airway open. This can include suctioning to clear secretions and employing airway adjuncts that can be used quickly with minimal restraint—such as an oropharyngeal airway if the patient is unconscious or has a reduced level of consciousness, or a nasopharyngeal airway if there’s no suspected skull fracture and the patient tolerates it. If airway patency remains in doubt despite these measures, call for and involve ALS for definitive, advanced airway management. Invasive airway procedures should not be attempted before safety is assured, and waiting for calm is not appropriate when the airway is at risk.