Airway & Breathing: Opening the Path for Oxygen

Airway patency comes first

Breathing problems are among the most common reasons people seek emergency care.¹ At the EMT-Basic level, “airway” means ensuring the upper airway is open so air can reach the lungs. Manual maneuvers—head-tilt chin-lift when spinal injury is not suspected, jaw-thrust when it is—remain the first tools before adjuncts or advanced techniques.

Listen and look: stridor, gurgling, or visible obstructions demand immediate action. Basic suction can clear fluids; solid obstructions may require finger sweeps only when you can see the object. Protecting the cervical spine while opening the airway is a core basic skill.

Evaluating breathing quality

Once the airway is open, assess whether breathing is adequate: rate, rhythm, depth, and effort. Nasal flaring, retractions, tripod positioning, and speaking in single words signal increased work of breathing. Pulse oximetry, when available, supplements—but never replaces—clinical observation.

Many patients with chronic lung disease live with lower baseline saturations.² Treat the patient: compare current findings to reported normals, watch for acute change, and support oxygenation per local protocol when signs of hypoxia or shock are present.

Oxygen and ventilation support

EMT-Basic scope typically includes oxygen delivery by nasal cannula, non-rebreather mask, and bag-valve-mask ventilation for apneic or severely inadequate breathing. Match the device to the patient’s need and reassess after every adjustment.

Document liters per minute, device type, and response. Effective basic airway and breathing care buys time—the foundation on which all other interventions rest.