Assessment usually involves examination before history as the majority of cases of airway compromise, either actual or potential, are evident by simple observation.
1. EXAMINATION - LOOKING FOR :
Signs of complete obstruction
- no air movement present
- grabbing at throat
- paradoxical breathing with extreme respiratory distress ie abdomen moves inwards while chest expands during attempted inspiration
- cyanosis
- agitation
Signs of partial obstruction
- still some air movement present
- stride, cough , self posturing if patient is conscious (eg sitting up and leaning forwards)
- use of accessory muscles of respiration
- hypnosis while breathing room air is a late sign of partial upper airway obstruction
Signs of potential obstruction
- normal air movement
- none of the above features
- swollen face, swollen tongue, sore throat, external neck trauma, circumferential neck burns, sooty sputum, burnt mouth/tongue/nasal hairs, history of fire or explosion in an enclosed space
Signs suggestive of difficult incubation
Signs of a non protected airway
- GCS 8 or less
- Absent gag/cough reflex
2. HISTORY - ASK ABOUT
symptoms of partial airway obstruction
- voice changes, cough, sore throat
Features which suggest potential airway obstruction
- burns in an enclosed space
- history of difficult incubation
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