When approaching the casualty, check for a response: a conscious, speaking patient is able to maintain his airway and needs no further airway manipulation. However, a patient’s consciousness level may deteriorate rapidly at any time and regular reassessment of the airway is vital. If obtunded, the patient requires rapid airway assessment and management; a low GCS may be the cause or the result of a blocked airway.

Look, listen and feel when assessing the airway:

1. Look for: signs of neck or maxillofacial trauma; any obvious airway obstruction in the mouth (tongue, vomit, foreign body, tissue swelling); signs of increased respiratory effort (use of accessory muscles, tracheal tug, seesaw chest, intercostal and subclavian recession) which may be indicative of an airway (or breathing) problem.
   
2. Listen for: snoring (pharyngeal obstruction, typically by tongue); gurgling (fluid in airway); stridor (upper airway obstruction); absent breath sounds may also point to a blocked airway (or respiratory arrest).
   
3. Feel for: exhaled air on your cheek.

Pre-hospital management of the obstructed airway should begin with simple manoeuvres. Head tilt and chin lift