Establishing an Emergency Airway

Abstract

The approach to a patient with acute airway obstruction should consist of an orderly series of steps: (1) prompt recognition of obstruction; (2) nonsurgical maneuvers to relieve obstruction; (3) mouth-to-mouth breathing to overcome obstruction or to diagnose persistent obstruction; and (4) establishment of an emergency surgical airway. Under emergency conditions an airway can be established rapidly, safely, and easily through the cricothyroid membrane. If it is necessary for an artificial airway to remain in place, a low tracheotomy should follow within 48 to 72 hours so that laryngeal stenosis will be avoided.