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What are the recommended techniques for basic airway management in adults in a primary care setting?
Answer
Recommended techniques for basic airway management in adults within a primary care setting focus on ensuring airway patency and effective ventilation using simple, non-invasive methods. Initial steps include positioning the patient to open the airway, typically by using the head-tilt-chin-lift or jaw-thrust maneuver if cervical spine injury is suspected, to prevent airway obstruction by the tongue or soft tissues 1. Basic airway adjuncts such as oropharyngeal airways (OPA) or nasopharyngeal airways (NPA) may be used to maintain airway patency if the patient is unconscious but has no gag reflex 1. Supplemental oxygen should be administered if available and indicated to support oxygenation 1. Manual ventilation with a bag-valve-mask (BVM) device is recommended if the patient is not breathing adequately, ensuring a good mask seal and appropriate ventilation rate to avoid gastric insufflation 1.
Recent evidence from simulated cardiac arrest scenarios in primary care paramedics suggests that while advanced airway devices like King laryngeal tubes can improve chest compression fraction, basic airway management techniques remain fundamental and effective in the primary care context, especially where advanced airway devices or specialist skills are not readily available (Jensen et al., 2013). This supports the guideline emphasis on mastering basic airway maneuvers and adjuncts before considering advanced airway interventions (Jensen et al., 2013).
In summary, primary care providers should prioritize airway positioning maneuvers, use of simple airway adjuncts (OPA/NPA), oxygen supplementation, and bag-valve-mask ventilation as the cornerstone of basic airway management in adults 1 (Jensen et al., 2013).
Key References
- NG39 - Major trauma: assessment and initial management
- NG119 - Cerebral palsy in adults
- NG202 - Obstructive sleep apnoea/hypopnoea syndrome and obesity hypoventilation syndrome in over 16s
- (Jensen et al., 2013): Chest compression fraction in simulated cardiac arrest management by primary care paramedics: King laryngeal tube airway versus basic airway management.
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