Airway is of paramount importance in any clinical setting. It must always be assessed first, and if any compromise or potential compromise is found, this must be dealt with as a first priority.
AN AIRWAY MUST BE :
1. Patent
Having a patent airway is an absolute first priority for any patient. An obstructed airway can be actual (i.e. partially or completely obstructed) or potential (eg airway burns which may result in progressive obstruction over the following few hours).
2. Protected
This is a relative priority. It does not take priority over the initial assessment and management of a patient's breathing and circulation.
An airway is unprotected when the normal protective reflexes are absent. This is most commonly associated with a decreased consciousness level. A GCS of 8 or less is usually associated with an unprotected airway.
Cervical spine protection is part of airway assessment and management. Any patient with a decreased level of consciousness, who has had trauma to the head or neck, or complains of neck pain, should be treated as having a potential cervical spine injury until proved otherwise. In line immobilization of the cervical spine or protection by a hard cervical collar must be provided while manipulating the airway.
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