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Prehospital protocol pediatric airway obstruction
From WikEM
Contents
Unconscious or Apneic?
No
If no signs of severe airway obstruction:
- Encourage coughing
Conscious with severe airway obstruction:
- Child: Abdominal thrusts
- Infant: Back blows/chest thrusts
- Perform until foreign body is expelled or patient becomes unconscious
Reassess
- Continue Supportive Care
- Place on NRB
- Monitor and transport
- Reassess for signs of complete airway obstruction and use BVM if needed
Yes
Begin chest compressions
- Open airway and remove any foreign body in mouth
- Begin BVM
Is there effective oxygenation and ventilation?
Yes
- Monitor and Transport
- Notify the receiving hospital
No
- Direct visualization of the foreign body
- Attempt to remove foreign body with McGill forceps
- Place ETT if necessary
Is there effective oxygenation and ventilation?
Yes
- Monitor and Transport
- Notify receiving hospital
No
- Advance ETT until the hub is at the teeth then withdraw the hub to normal level
- Use small tidal volumes for ventilation
- If unable to establish an airway rapidly transport to the nearest faciltity
- Contact medical control
