Which airway management approach is recommended for an unconscious casualty with suspected facial injury when skull fracture cannot be ruled out?

Which airway management approach is recommended for an unconscious casualty with suspected facial injury when skull fracture cannot be ruled out?

• A. Head-Tilt/Chin-Lift With An Nasopharyngeal Airway
• B. Blind Finger Sweep
• C. Jaw-Thrust Maneuver And An Oropharyngeal Airway If Trained; Avoid Blind Finger Sweeps And Nasal Airway If Skull Fracture Suspected
• D. Immediate Cricothyrotomy

Answer: (C)

In trauma airway care, protecting the neck while keeping the airway open is the priority. When skull fracture cannot be ruled out, the safest approach is to use a jaw-thrust maneuver to move the mandible forward and lift the tongue away from the back of the throat, helping to open the airway without extending or flexing the neck. If trained, insert an oropharyngeal airway to maintain patency, since it helps prevent the tongue from collapsing back into the airway in an unconscious patient who lacks a protective gag reflex. Avoid the head-tilt/chin-lift because it can require moving the neck and worsen possible spinal or skull injuries. Nasal airways are not used when skull fracture is suspected due to the risk of entering the cranial cavity or causing significant nasal trauma. Blind finger sweeps are discouraged because they can push an obstruction deeper or cause injury, especially in an unconscious patient where the airway is already compromised. Cricothyrotomy remains a last resort if noninvasive methods fail to secure the airway.

In trauma airway care, protecting the neck while keeping the airway open is the priority. When skull fracture cannot be ruled out, the safest approach is to use a jaw-thrust maneuver to move the mandible forward and lift the tongue away from the back of the throat, helping to open the airway without extending or flexing the neck. If trained, insert an oropharyngeal airway to maintain patency, since it helps prevent the tongue from collapsing back into the airway in an unconscious patient who lacks a protective gag reflex.

Avoid the head-tilt/chin-lift because it can require moving the neck and worsen possible spinal or skull injuries. Nasal airways are not used when skull fracture is suspected due to the risk of entering the cranial cavity or causing significant nasal trauma. Blind finger sweeps are discouraged because they can push an obstruction deeper or cause injury, especially in an unconscious patient where the airway is already compromised. Cricothyrotomy remains a last resort if noninvasive methods fail to secure the airway.