What is the recommended way to establish a patent airway?
• The first attempt to establish airway patency should be through proper airway positioning . Often, this step alone will be effective. Because most airway obstruction is due to the effect of gravity on the mandibular block of soft tissues, it can be relieved by either a head-tilt chin-lift or jaw-thrust maneuver.
• Vomitus or other foreign material can also obstruct airways. Inspect the airway for these materials, and suction early and frequently .
• In selected patients with altered levels of consciousness, nasopharyngeal or oropharyngeal airway stents are useful. Semiconscious children generally tolerate nasopharyngeal airways better than oropharyngeal airways. Children, such as those in postictal states, who have sustained spontaneous respiratory effort but have upper airway obstruction due to poor muscle tone often benefit from the use of these devices.
• Although jumping straight to intubation is often tempting, proper positioning with appropriately sized mask and bag-valve device is often the most efficacious way to quickly intervene and immediately manage an airway during resuscitations.
• The laryngeal mask airway is a relatively new and underused supraglottic advanced airway device that may be a very useful tool to the experienced user in certain situations.