Most EMS patients are conscious and speaking with EMS. Sometimes, the patient will not be alert or even unconscious, necessitating the ambulance crew to open the airway and determine if the airway is clear. In either case the airway is clear, but does that mean that the airway will remain clear during transport?

Unconscious patients are the most at risk for aspiration (choking on blood or vomit). When a cervical spine injury is not suspected, laying the patient on their left side decreases the risk of aspiration in the even the patient vomits (or vomits again).

Conscious patients literally tell you that their airway is clear, so it’s easy to take for granted that the patient’s airway will remain clear. The following are patients whose airway status should constantly be assessed due to the dynamic nature of the condition:

• Anaphylaxis
• Any patient who had been ventilated prior to transport
• Any patient with a history of a foreign body airway obstruction prior to transport
• Any patient with a history of being asphyxiation prior to transport
• Any smoke inhalation or burn patient