4-1 PEDIATRIC FOREIGN BODY-AIRWAY OBSTRUCTION

EMR - Emergency Medical Responder

1. All patients will be assessed immediately as to patency of the airway and adequacy of respirations.
2. Aggressive airway management is indicated if any of the following exist:
   1. Cardiac or respiratory arrest
   2. Obstructed airway
   3. Unconscious patient
   4. Respiratory distress with labored, shallow, or rapid respiration
3. When aggressive management is indicated, the following sequence should be initiated:
   1. Open the airway via chin lift or modified jaw thrust.  Protect the C-spine unless no chance of trauma.
   2. Attempt assisted ventilations, using a Bag-Valve-Mask, if available.
   3. If unable to ventilate, reposition airway and attempt ventilation again.
   4. If unable, use age appropriate techniques to dislodge the obstruction utilizing back blows with chest thrusts for infants and chest compressions for children one year or older.
4. Call for ALS intercept
5. Assess circulation, perfusion and mental status.
6. If aggressive management is not indicated and airway is intact, administer supplemental oxygen.

EMT - Emergency Medical Technician  Perform/Confirm All Above Interventions

1. Assess for adequacy of ventilation. If insufficient:
   1. Open the airway via chin lift or modified jaw thrust.  Protect the C-spine unless no chance of trauma.
   2. Attempt assisted ventilations using a BVM (Bag-Valve-Mask) device with high flow, 100% concentration oxygen.
   3. If unsuccessful, establish a direct view of the object and attempt to remove it with Magill forceps, if trained to do so and repeat step B
   4. Initiate rapid transport and Contact MEDICAL CONTROL to request ALS intercept.

AEMT – Advanced Emergency Medicine Tech   Perform/Confirm All Above Interventions

Intermediate - Perform/Confirm All Above Interventions

1. Evaluate for endotracheal intubation if trained to do so.

Paramedic - Perform/Confirm All Above Interventions

1. Contact Medical Control for further orders.