Description

introduCtion

Airway management and ventilation are the first and most criti-
cal steps in the primary assessment of every patient you will

encounter (unless the patient is in cardiac arrest, when chest

compressions will come first). Airway management and ven-
tilation go hand in hand. You must immediately establish and

maintain an open airway while providing adequate oxygen de-
livery and carbon dioxide elimination for all patients. Without

adequate airway maintenance and ventilation, the patient will
succumb to brain injury or even death in as little as 4 minutes.

Early detection and intervention of airway and breathing prob-
lems, including dispatcher-guided interventions by bystanders,

are vital to patient survival.
Airway management and ventilation have always been
taught to occur in a stepwise (linear) process. Recommended

sequences include the standard ABC (airway, breathing, cir-
culation) sequence, as well as the CAB (compressions, airway,

breathing) sequence recommended by the American Heart
Association for a patient who appears to be in cardiac arrest

when chest compression must come first. These established se-
quences (ABC and CAB) can help rescuers remember what to

do in emergency situations.

With regard to airway and/or ventilation problems, para-
medics should approach the patient more globally and consider

the whole picture, rather than blindly following predeter-
mined steps. You cannot assess an airway if the patient is not

breathing. You cannot assess breathing if there is no airway.
Therefore, airway and ventilation need to be considered