Even though they're written out in two separate protocols, the adult and pediatric approaches to the obstructed airway are effectively the same, with the pediatric protocol including considerations for uncuffed endotracheal tubes.
Aside from that, in both instances, CFRs will promote coughing and initiate “airway maneuvers” (think abdominal thrusts, back blows, etc.)
BLS, you’ll notice, will initiate transport, but only after requesting ALS assistance. The reasoning behind this is that if ALS can assist with airway management, great, but if it will take longer for paramedics to arrive than it would to get the patient to the hospital, it may make more sense to just transport to the ED for further management.
If on scene, ALS can perform actual airway interventions, starting with direct laryngoscopy and attempted removal of foreign bodies with Magill forceps. If unsuccessful, they may place an endotracheal tube to maintain the airway, advancing it down the right mainstem bronchus for persistent difficulty with ventilation.
That’s all they got! Maybe someday we’ll see fiber optic bronchoscopes in the backs of ambulances, but until then, you’ll still have something to do when the patient reaches the ED!
www.nycremsco.org or the protocols binder for more!
Dave