b'D R S A B C DhapterAirwayChapter A blocked airway will cause breathing to stop. Soon after the heart will stop beating and this will lead to death. It is essential for an airway to be open and clear of any obstructions.A blocked airway can be caused by: The tongue - when a patient is unconscious, all muscles quickly relax. If the patient is lying on their back, the tongue (a muscle) which is attached to the back of the throat, falls against the back wall of the throat and blocks air from entering the lungs.Foreign material such as vomit, food, blood. An unconscious patient is unable to swallow or cough out foreign material. This may cause airway obstruction or laryngeal irritation and foreign material may enter the lungs.Trauma or injury to the airway.Swelling (e.g. Anaphylaxis,refer to page 182 ).In an unconscious patient, care of the airway takes precedence over any other injury, including the possibility of a neck and spinal injury.How to Open, Check and Clear the Airway All unconscious patients should be handled gently with no twisting or bending of the spinal column and especially the neck. If it is necessary, move the head gently to obtain a clear airway. If the airway is not clear and foreign material is obstructing the airway, roll the patient onto their side to clear the airway. The mouth should beopened and turned slightly downwards to allow any obvious foreign material to drain using gravity.Loose dentures should be removed, but well-fitting ones can be left in place. Visible material can be removed by the rescuers fingers. (Finger Sweep) With the patient on their back, kneelbeside their head and use a combination of Backward Head Tilt with Chin Lift.One hand is placed on the forehead while the other hand is used to provide chin lift. The head is tilted backwards (not the neck). The chin is held up by the thumb and fingers in order to open the mouth. The tongue and soft tissues will fall away from the back ofthe throat.Resuscitation 41'