The prehospital approach to the obstructed airway shows a nice progression of responsibilities based on level of training. CFRs at the most basic level will encourage coughing and other AHA-recommended choking maneuvers. BLS crews will request ALS backup, but if their expected arrival time is longer than the time it would take to transport to the hospital, they will transport the patient, again attempting to perform basic maneuvers to clear the airway.
If ALS providers are on scene, they will perform DL to attempt to manually remove the obstruction with Magill forceps; if unsuccessful, the subsequent steps walk through how to intentionally right mainstem the foreign body while obtaining an advanced airway.
Not a lot to do on the OLMC side other than to be aware of this stepwise progression, as well as have an understanding of pre-intubation sedation options if needed. What are those options? Stay tuned – the answer may…take your breath away?
www.nycremsco.org and the protocol binder for more!
Dave