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Category: FB Airway Obstruction Cardiac Arrest

FBAO management from unconscious to VSA

Question #: 358

Question:


PCP paramedics arrive on scene to a unresponsive patient with a pulse but respiratory arrest due to obstruction. The goal will be Chest compressions for the purpose of airway clearing. At what time should a full reassessment (CAB) be completed? It is expected that the patient will lose their pulse if airway not cleared quickly. IF the airway is not cleared do Paramedics stop attempts to clear, recheck pulse and proceed down FBAO protocol if pulseless? OR continue with attempts to clear airway before moving on? Rapid transport is occuring.

Answer:


Thank you for our discussion regarding the MedicASK question. Here is a brief summary of what we covered.

If the patient becomes unresponsive, it is appropriate to assess for a pulse as there's a change in the level of awareness/CAB. Should the patient be vital signs absent, you can initiate the FBAO Cardiac Arrest directive which includes one analysis only.

If the patient is unconscious, but not yet in cardiac arrest, AHA guidelines recommend healthcare providers to check for a pulse periodically. AHA guidelines recommend lay rescuers to apply SAED right away.

When keeping in mind the work environment, system and medical directives we work with, it may be easier to monitor/reassess for a pulse after completing 5 cycles (2 minutes) of compressions.

Even if the patient is in cardiac arrest, the focus/patient care goals should still be to remove the obstruction removal and early extrication/transport.

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