Prehospital protocol pediatric airway obstruction

Unconscious or Apneic?

No

If no signs of severe airway obstruction:

• Encourage coughing

Conscious with severe airway obstruction:

• Child: Abdominal thrusts
• Infant: Back blows/chest thrusts
• Perform until foreign body is expelled or patient becomes unconscious

Reassess

• Continue Supportive Care
• Place on NRB
• Monitor and transport
• Reassess for signs of complete airway obstruction and use BVM if needed

Yes

Begin chest compressions

• Open airway and remove any foreign body in mouth
• Begin BVM

Is there effective oxygenation and ventilation?

Yes

• Monitor and Transport
• Notify the receiving hospital

No

• Direct visualization of the foreign body
• Attempt to remove foreign body with McGill forceps
• Place ETT if necessary

Yes

• Monitor and Transport
• Notify receiving hospital

No

• Advance ETT until the hub is at the teet then withdraw the hub to normal level
• Use small tidal volumes for ventilation
• If unable to establish an airway rapidly transport to the nearest faciltity
• Contact medical control