Identifying Airway Compromise

Conscious patients

Conscious patients with airway compromise will typically sit upright and look distressed. Make sure to examine for:

• Swollen tongue (angioedema or anaphylaxis)
• Sooty sputum (following a thermal injury)
• Neck haematomas (following blunt or penetrating trauma)
• Rashes (anaphylaxis or poisoning)
• Laboured breathing and wheeze (asthma)
• Facial fractures
• Crepitus and surgical emphysema (laryngeal injury)

Unconscious patients

In unconscious patients examine for:

• Snoring or added airway noises (indicative of partial airway obstruction)
• Abnormal chest and abdominal wall movement (suggestive of airway obstruction)
• Lack of fogging of the oxygen mask

Fig 1: Lack of fogging of the oxygen face mask during normal inspiration	Fig 2: Fogging of the oxygen face mask due to normal expiration