1. Any blood, mucus or vomit must be removed from the upper respiratory passages by suction or swabbing. Dentures should be looked for and extracted. In the more minor situations, respiratory obstruction may be avoided by support of the jaw. a simple airway, and turning the patient on their side.
2. An endotracheal lube may have to be passed:
(a) in the unconscious patient with an absent gag reflex
(b) where inhalation of mucus or vomit luis already taken place (or is suspected), for clearing of the respiratory passages under vision
(c) where there is bleeding from the upper airway
(d) for the more effective management of cases where there is respiratory difficulty or evidence of hypoxia, e.g. in cases of Hail chest. Where there is need for intubation in a patient with a suspected cervical spine injury, the procedure should be carried out with great care, avoiding excessive cervical spine extension: naso-tracheal intubation should be used. Confirm placement by auscultation (and/or by a radiograph).
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