Chapter 4: ACLS | American CPR Care Association

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chapter 4 : Airway tools

It is imperative to know the proper usage of the equipment and techniques necessary for the management of various cardiac problems.

Basic Airway Tools and Techniques

Obstruction of the airway during cardiac arrest is usually due to the relaxation of muscles in the throat causing the tongue to fall back and occlude the airway. The methods to open the airway include: head tilt–chin lift, jaw thrust, mouth-to-mouth ventilation, mouth-to-nose ventilation, mouth-to-barrier device ventilation, and bag-mask ventilation.

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The head tilt–chin lift is the best method for opening the airway.

  1. Place your hand on the patient’s forehead.
  2. Apply pressure with the palm of your hand and that will tilt the head back.
  3. Put the fingertips of your other hand under the chin and lift the chin with your fingertips until the mouth is open.

The jaw thrust method is used when there is a suspected head or spinal cord trauma.

  1. Lift the jaw upward with the index, middle and ring fingers of both hands, while using your thumbs to open the jaw.

Bag-Mask Ventilation:  This device has a ventilation bag attached to a face mask and provides positive pressure ventilation of 500-600 mL tidal volume.

  1. Perform head tilt–chin lift to open the airway while holding the mask against the face.
  2. Circle the thumb and first finger around the top of the mask forming a “C” while using the third, fourth, and fifth finger to lift the jaw (forming a “E”).

Advanced Airway Tools and Techniques

There are many different devices used for advanced airway access and their use depends upon the training of the individual administrating the technique.

  1. Laryngeal mask airway
  2. Laryngeal tube
  3. Esophageal-tracheal tube
  4. Endotracheal tube

Learning Outcomes:You have completed Course IV. Now you should be able to:

  1. Recognize the different airway devices
    • Bag-Mask Ventilation
    • Advanced airway
  2. Understand the techniques in opening the airway