First Responder EMS Curriculum for Training Centers in Eurasia

. Finger SweepsThis method involves using your fingers to remove solid objects from the patient’sairway. Remember to use body substance isolation. If foreign material or vomit isvisible in the mouth, remove it quickly as the patient may inhale the foreign matter intothe lungs with the next breath. Do not perform blind finger sweeps in infants orchildren.Technique1. If uninjured, roll the patient onto his/her side.2. Wipe out liquids or semi-liquids with the index and middle fingers covered with acloth.3. Remove solid objects with a hooked index finger.c. SuctioningThis method uses negative pressure to keep the airway clear. A patient needs to besuctioned immediately when you hear a gurgling sound during breathing or ventilation.Suction is only indicated if the recovery position and finger sweeps are ineffective indraining the airway or trauma is suspected and the patient cannot be placed in therecovery position. The purpose of suctioning is to remove blood, other liquids, and foodparticles from the airway. Most suction units are inadequate for removing solid objectssuch as teeth, foreign bodies, and food. Portable suction equipment is available and maybe manually or electrically operated.Principles1. Observe body substance isolation.2. A hard or rigid "tonsil sucker" or "tonsil tip" is preferred to suction the mouth of anunresponsive patient.3. The tip of the suction catheter should not be inserted deeper than the base of thetongue.4. Because air and oxygen are removed during suction, it is recommended that yousuction for no more than 15 seconds.• Decrease time in infants and children• Infants 5 seconds• Children 10 seconds5. Watch for decreased heart rate in infants.6. If you note a decrease in heart rate, stop suctioning and provide ventilation.7. Determining Presence of BreathingImmediately after opening the airway, check to see whether the patient is breathing. As youdetermine the presence of breathing, look at the effort or work of breathing. Normalbreathing should be effortless. Observe the chest for adequate rise and fall. Look foraccessory muscle use (contractions). The accessory muscles of respiration are in the chestwall and neck.Techniques1. In patients who are responsive, ask: "Can you speak, are you choking?" The abilityto talk or make vocal sounds indicates that air is moving past the vocal cords.2. In patients who are unresponsive, maintain an open airway and place your ear closeto the patient’s mouth and nose.66First Responder EMS Curriculum/AIHA, July 2002