> For the complete documentation index, see [llms.txt](https://handbook.teddwa.xyz/llms.txt). Markdown versions of documentation pages are available by appending `.md` to page URLs; this page is available as [Markdown](https://handbook.teddwa.xyz/airway-problems.md).

# Airway problems

Identify airway compromise, support ventilation, and treat immediate causes.

### Identify airway compromise

Look for hoarseness, muffled voice, drooling, inability to speak full sentences, accessory-muscle use, cyanosis, reduced consciousness, or a silent chest.

Treat worsening work of breathing, altered mental status, falling oxygen saturation, or poor chest rise as immediate threats.

{% hint style="danger" %}
A quiet or silent airway can indicate critical obstruction. Do not wait for oxygen saturation to fall before acting.
{% endhint %}

### Immediate actions

1. Complete the primary assessment (ABCs) and call for additional support.
2. Position the patient to maintain their airway, unless trauma requires manual stabilization.
3. Suction visible secretions, blood, or vomit. Apply high concentration oxygen.
4. Assist ventilation with a bag valve mask when breathing is inadequate.

Use an oropharyngeal airway for an unconscious patient without a gag reflex. Use a nasopharyngeal airway for a patient who cannot tolerate an oropharyngeal airway, unless facial or skull base trauma is suspected.

### BLS and ALS care

Apply continuous oxygen saturation monitoring. Use waveform capnography when available for assisted ventilation or advanced airways.

ALS should establish IV or IO access. Treat severe pain with fentanyl, morphine, or ketamine when appropriate. Prepare for a definitive airway when ventilation or oxygenation fails.

### Select a guide

* [Airway swelling and anaphylaxis](/airway-problems/airway-swelling-and-anaphylaxis.md)
* [Foreign-body airway obstruction](/airway-problems/foreign-body-airway-obstruction.md)
* [Airway trauma and inhalation injury](/airway-problems/airway-trauma-and-inhalation-injury.md)

{% hint style="warning" %}
Reassess airway patency, respiratory rate, chest rise, oxygen saturation, mental status, and capnography throughout transport.
{% endhint %}


---

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