PARAMEDIC STANDING ORDERS:

• If basic foreign body airway maneuvers fail, consider any of the following:
  • In unresponsive patients, visualize the posterior pharynx with a laryngoscope to potentially identify and remove the foreign-body using Magill forceps.
  • If obstruction is secondary to trauma or edema, or if uncontrollable bleeding into the airway causes life-threatening ventilation impairment, perform endotracheal intubation. See Orotracheal Intubation Procedure (6 Skills).
  • Consider forced right mainstem intubation (with pullback) to allow for ventilation of left lung in the extreme event of lower tracheal foreign body obstruction and inability to ventilate.
  • If unable to intubate and the patient cannot be adequately ventilated by other means, perform cricothyrotomy. See Percutaneous Cricothyrotomy Procedure (10 Skills)

INDICATION:

If air exchange is adequate with a partial airway obstruction, do not interfere; instead, encourage the patient to cough up the obstruction. Continue to monitor the patient for adequacy of air exchange. If air exchange becomes inadequate, continue with the protocol.