Postural Drainage for Airway Management

The Importance of Proper Positioning

When dealing with a patient's airway, especially when they are lying on their back or are unconscious, it's crucial to prevent fluid or stomach contents from obstructing the airway. This includes blood or any other liquid substances. Proper positioning can make a significant difference in airway management during patient transfer or travel.

Positioning for Airway Protection

• 1. Sitting Up Slightly: Ensure that the patient is positioned slightly upright. This helps prevent the contents from flowing back into the airway and keeps them in the stomach.
• 2. Oxygen Mask Considerations: When a patient is on oxygen, be aware that the mask can trap fluids or vomit. Inhaling these substances can lead to aspirational pneumonia, a life-threatening condition. In such cases, promptly remove the mask from the airway.
• 3. Head Elevation: Place one hand under the back of the patient's head. This not only elevates the head slightly but also prepares for postural movements if needed for airway drainage.

Natural Airway Drainage

Facilitating natural drainage can be quicker and more effective in some situations:

• 1. Rolling the Patient: If a substantial amount of fluid is present in the back of the throat, rolling the patient onto their side can rapidly drain the fluid onto the floor. This approach is faster than relying solely on a suction unit, which may take more time.
• 2. Recovery Position: The recovery position promotes natural airway drainage. It causes the tongue and jaw to fall forward, allowing fluids to drain naturally through the mouth and airway. Unconscious casualties should be placed in the recovery position until professional help arrives.
• 3. Ambulance Technique: In an ambulance, a similar technique can be used. Position the patient with one arm under the back of the head, raise the opposite knee, and tuck the foot underneath the opposite leg. Lift the wrist across the chest and press down on the knee to roll the patient to the side, allowing them to vomit to the floor, clear the airway, and then return to a normal position.

Proper positioning and postural drainage are essential for effective airway management and patient safety.