Basic Airway Management in BLS

Maintaining a patent airway is a fundamental skill in Basic Life Support (BLS). As a healthcare provider, you must ensure effective oxygenation and ventilation while minimizing interruptions in CPR.

Key Concepts in Airway Management

• Ensuring an open airway using the correct maneuvers.
• Providing effective bag-mask ventilation (BVM) without over-inflation.
• Recognizing and managing airway obstruction.
• Coordinating ventilation with CPR to maintain perfusion.

Opening the Airway

1. Head Tilt-Chin Lift vs. Jaw Thrust Maneuver

Proper airway positioning is the first step in effective ventilation. Use the correct maneuver based on the situation:

• Head Tilt-Chin Lift: Preferred for patients without suspected spinal injury.
• Jaw Thrust Maneuver: Used if spinal injury is suspected (e.g., trauma patients).

Regardless of the maneuver used, always ensure:

• The tongue is not obstructing the airway.
• There are no visible foreign bodies blocking airflow.
• Rescue breaths result in visible chest rise.

Bag-Mask Ventilation (BVM)

1. Proper BVM Technique

Bag-mask ventilation (BVM) is the preferred method for providing assisted breaths in a healthcare setting. To ensure effective ventilation:

• Position yourself directly above the patient’s head.
• Use the E-C Clamp Technique to seal the mask:
  • Place your thumb and index finger around the mask (forming a “C”).
  • Use your remaining three fingers to lift the jaw (forming an “E”).
• Squeeze the bag over 1 second per breath while observing chest rise.
• Avoid over-ventilating, as excessive volume can cause gastric inflation and reduce cardiac output.

2. Common BVM Mistakes & How to Fix Them

• Poor mask seal → Adjust hand positioning (E-C clamp), reposition the mask, or use two hands.
• Insufficient chest rise → Reassess airway positioning, check for obstructions, or reposition the head.
• Gastric inflation → Reduce breath volume and pressure; ensure slower, controlled breaths.

Minimizing Interruptions While Maintaining Effective Ventilation

• Coordinate ventilations with compressions to reduce “no flow” time.
• Use a two-person BVM technique when possible for better airway control.
• Monitor for chest rise to confirm effective breaths.

Mastering these basic airway techniques ensures proper oxygenation while minimizing interruptions in CPR. Now, let’s move into Advanced Airway Management, where we discuss the use of airway adjuncts (OPAs & NPAs).