Out-Of-Hospital ACLS Airway Management Megacode: The Best Strategies for Saving Lives

After assessment of the initial impression and primary assessment, the woman becomes unresponsive.

What are your next actions?

1. Check responsiveness: Tap the shoulders and shout, “Are you okay?” There is no response.
2. Activate the emergency response system. You direct the second rescuer to activate the emergency response system and get an AED.
3. Check for breathing: Look for visible chest rising and falling. No breathing present.
4. Check for a pulse: Place your fingers on the inside of the patient’s neck, just below the angle of the jaw. You will palpate the carotid pulse for no more than 10 seconds. Pulse is present but weak.

What are your next actions?

1. Pulse is present so we will not begin CPR starting with compressions.
2. The decision between oropharyngeal or nasopharyngeal airway can be difficult, but there are a few things to consider when making the decision.
3. Oropharyngeal airways are inserted into the mouth, and nasopharyngeal airways are inserted into the nose. Oropharyngeal airways are more likely to be successful the first time, but nasopharyngeal airways are less likely to cause vomiting.
4. Administer oxygen. Oxygen saturation is less than 50%. 
5. Perform bag-mask ventilation for 1 minute effectively at the proper rate (1 breath every 6 seconds), speed (over 1 second), and volume (about half a bag).

The woman is stable and oxygen saturation is rising. What are your next steps?