EMT Optional Skills Training Course
Module 3: Airway Management
Introduction
Airway management
Adding to your toolbox
Airway management is one of the most critical skills for every level of EMS provider. Ensuring a clear and functional airway can mean the difference between life and death in many emergencies, from trauma and cardiac arrest to medical conditions like anaphylaxis or respiratory failure. This module provides an overview of key airway management concepts, including airway anatomy, respiratory physiology, assessment techniques, basic and EMT-OS interventions, and proper use of equipment.
Module Content
Airway Anatomy & Physiology
Objectives
EMT-OS Airway Skills
BLS Airway Review
Objectives
OBJECTIVES
At the completion of this module, you will be able to:
identify upper and lower airway anatomy
Describe respiratory physiology
Describe indications and contraindications for bls airways
Describe appropriate suction techniques
Describe appropriate ventilation techniques
Describe indications and contraindications for supraglottic airway placement
Demonstrate how to properly size a supraglottic airway for an adult patient
Demonstrate appropriate palcement of supraglottic airway
Idenitfy how to properly monitor airway after supraglottic airway placement
module Topics
MODULE Topics
airway anatomy & physiology
BLS Airway review
EMT-OS Airway skills
Learn how to measure, insert, and monitor supraglottic airway devices.
Review BLS airways, suction, and ventilation.
Review airway anatomy and physiology.
airway anatomy and physiology
Airway A&P Intro
The airway provides the structure for air to move in and out of the body. This is an essential function that is a key focus of initial EMS care. Maintaining a patent airway is a critical step to all other EMS interventions. In this module, you will review airway anatomy and physiology, and reivew BLS airway management. You will also be introduced to supraglottic airways as part of the EMT-OS scope of practice.
airway anatomy and physiology
upper Airway Anatomy review
Select each icon to review the structures of the upper airway.
airway anatomy and physiology
lower Airway Anatomy review
Select each icon to review the structures of the lower airway.
Make sure to review the airway anatomy diagrams in your workbook.
airway anatomy and physiology
Tour The airway
Watch the video to see a live view of the anatomy of the airway.
Original Video Source: MedicalMavericksTV
airway anatomy and physiology
Click only on the correct components of the upper & lower airway
Lower Airway
Upper Airway
Carina
Nasopharynx
Vallecula
Carina
Alveoli
Epiglottis
Oropharynx
Alveoli
Cricoid cartilage
Trachea
Bronchus
Oropharynx
Esophagus
Trachea
Bronchiole
Pharynx
Check
Check
airway anatomy and physiology
Ventilation vs. Respiration
Watch the video to learn more about the difference between ventilation and respiration.
airway anatomy and physiology
Key takeaways
Understand Airway structures
Ventilation vs. Respiration
The structures of the airway provide protection to the patient in various ways. Anything that moves down into the lower airway can increase the risk of infection for the patient.
Remember that we need to ensure that patients can move air in and out (ventilation), and that they also have good gas exchange (respiration).
bls airway review
BLS airway review
BLS airway skills are the core of all airway skills in EMS. Having a mastery of the basic skills before adding new tools to your toolkit is essential. In this section, you will review BLS airway skills including opening the airway, suctioning, ventilating a patient, placing a BLS airway, and monitoring a patient using ETCO2.
bls airway review
opening the airway
Watch the video to review OPA placement. Then, select the icons below for more OPA tips.
bls airway review
Suction review
Select each image to review the key points of suctioning.
Hard tip suction catheters can be used for large amounts of fluid or vomit. Do not suction further than you can see to avoid stimulating the gag reflex. Soft-tip catheters can be used for pediatrics and to suction ET tubes or suppraglittic airways. Apply suction only on the way out of the mouth and limit suctioning to 10 seconds when possible.
Saline or sterile water can be used to clear the suction catheter if it becomes clogged during suctioning.
Suction units can be powered or manual. If using a powered suction, make sure to check the batteries at the beginning of each shift. Powered suction units should generate 300 mmHg when clamped.
bls airway review
Ventilation review
Hover over each icon to review key points of BVM ventilation.
bls airway review
oropharyngeal airway review
Watch the video to review OPA placement. Then, select the icons below for more OPA tips.
bls airway review
nasopharyngeal airway review
Watch the video to review NPA placement. Then, select the icons below for more NPA tips.
bls airway review
Scenario
Read the scenario, then select the button below to manage the airway. Once the window opens, you will have 10 seconds to select the items you will need to manage this patient's airway.
You arrive on scene to find a 58 y/o female unresponsive on the couch. She has a faint, slow pulse, but is apneic and cyonotic around her lips. Your crew moves her to the ground and you are directed to manage her airway. When you open the airway with a head-tilt, chin lift, there does not appear to be any obstructions.
Manage the Airway
bls airway review
Scenario
Read the scenario, then select the button below to manage the airway. Once the window opens, you will have 10 seconds to select the items you will need to manage this patient's airway.
You arrive on scene to find a 72 y/o female with chest pain and shortness of breath. She has one-word dyspnea and has been coughing up pink sputum. Her SpO2 is 78%.
Manage the Airway
bls airway review
Scenario
Read the scenario, then select the button below to manage the airway. Once the window opens, you will have 10 seconds to select the items you will need to manage this patient's airway.
You arrive on scene to find a 40 y/o male on the kitchen floor. He is semi-conscious and groans to painful stimuli. His breathing is slow and shallow at around 4 breaths per. There is an empty pill bottle on the counter of antidepressant medication that was filled yesterday.
Manage the Airway
bls airway review
ETCO2 Review
Watch the video to learn more about capnography. Hover over the icons below for more ETCO2 tips.
bls airway review
Scenario
You arrive on scene to find a 60 y/o M in cardiac arrest at the pool. Bystanders removed him from the pool and are performing CPR. Your crew takes over and starts compressions and ventilations. Select the capnography to review the patient's initial capnography reading. Then, select the button below to answer Question 1.
Question 1
bls airway review
After 8 minutes of CPR, you see the following ETCO2 reading:
bls airway review
Scenario
You arrive on scene to find a confused 26 y/o M breathing fast and deep. His roommates tell you he is a type 1 diabetic who ran out of insulin and so they tried to give him juice when they noticed he was confused, but it didn't help. His skin is hot and dry and his breath smells like citrus. SpO2 is 96%. Select the capnography to review the patient's capnography reading. Then, select the button below to answer Question 1.
Question 1
emt-os airway skills
emt-os airway skills Intro
EMT-OS adds an additional airway skill to your toolkit that allows you to better protect patient's airways. It is important to understand how to use this new skill correctly. This section will cover the indications and contraindications, sizing, and confirming placement for a supraglottic airway. SBEMSA has approved the i-gel as the supraglottic airway for Santa Barbara County, so this training will focus on the i-gel. Before you start this section, review Policy 533-02 and Policy 546 in your workbook or by clicking the links below.
Policy 533-02
Policy 546
emt-os airway skills
Supraglottic Airways: i-gel
Click the icons to learn more about the benefits of using a supraglottic airway.
Relatively easy to insert
Less fatigue to providers
Lowers aspiration risk (if placed correctly)
May relieve anatomical obstruction
emt-os airway skills
deciding to use an i-gel
select each card to learn when placing an i-gel is appropriate
Contraindications
Indications
- Conscious or intact gag reflex
- Upper airway FBAO
- Caustic ingestions
- Trismus or trauma (blocking airway)
- Respiratory failure or arrest
- Cardiac arrest
Indications
Contraindications
emt-os airway skills
i-gel sizing
once you decide you need to place an airway, size it appropriately
Using an appropriate sized airway is important for every airway we use in EMS. Supraglottic airways, especially the i-gel, need to be properly sized so they seat correctly over the glottic opening to protect the airway. Remember that EMT-OS providers can only place supraglottic airways for adult patients!
bls airway review
Size the airway
You arrive on scene to find a 17 y/o female in respiratory arrest after taking a bottle of tylenol. She has a weak pulse. Your crew is ventilating the patient while you set up to place an i-gel. The patient weighs 77 pounds.
bls airway review
Size the airway
You arrive on scene to find a 32 y/o male in cardiac arrest. Your crew suctions and is ventilating the patient while you set up to place an i-gel. The patient weighs 450 pounds.
emt-os airway skills
Placing the i-gel
Scroll through the images to see the steps to placing an i-gel. Remember to have suction, a stethoscope, capnography, and the BVM prepared prior to placing the i-gel.
emt-os airway skills
PLace the I-gel
Watch the video to see an example of placing an i-gel on a cadaver.
emt-os airway skills
Verify i-gel placement
select the icons to learn more about how to verify i-gel placement
bls airway review
Scenario
1 of 6
Read the scenario, then answer each question to managing his airway.
You arrive on scene to find a 46 y/o male on the ground after falling from the roof of a building. He is unconscious and has agonal breathing. There is bleeding to his head and mouth.
bls airway review
Scenario
2 of 6
You arrive on scene to find a 46 y/o male on the ground after falling from the roof of a building. He is unconscious and has agonal breathing. There is bleeding to his head and mouth. After opening the airway, you notice blood in the airway, but the patient does not gag.
bls airway review
Scenario
3 of 6
You arrive on scene to find a 46 y/o male on the ground after falling from the roof of a building. He is unconscious and has agonal breathing. There is bleeding to his head and mouth. You have now cleared the airway and are deciding how to begin ventilating the patient.
bls airway review
Scenario
4 of 6
bls airway review
Scenario
5 of 6
bls airway review
Scenario
6 of 6
county policies
Module 3 completion and study
review the following policies online or in your workbook
Policy 533-02
Policy 546
Airway Management
Supraglottic Airway Device
Note: you must complete the ems medical director overview of i-Gel for Expanded Scope in order to complete module 3!
References
MOdule references
Alexander, M., & Belle, R. (2016). Advanced EMT: A clinical reasoning approach (2nd ed.). Pearson Education. Limmer, D., O'Keefe, M., & Dickinson, E. T. (2020). Emergency care (14th ed.). Pearson Education. Scanlon, V. C., & Sanders, T. (2015). Essentials of anatomy and physiology (7th ed.). F. A. Davis Walls, R. M., & Murphy, M. F. (Eds.). (2012). Manual of emergency airway management (4th ed.). Wolters Kluwer / Lippincott Williams & Wilkins. ResusMonitor. (n.d.). ResusMonitor: Simulation patient vitals monitor [Web application]. Retrieved July 8, 2025, from https://resusmonitor.com/ Intersurgical Inc. (n.d.). i‑gel® O₂ Resus Pack. Intersurgical Inc. Retrieved July 8, 2025, from https://www.intersurgicalinc.com/products/airway-management/i-gel-o-resus-pack MedicalMavericksTV. (2012, April 4). Broncoscopy Procedure - See inside the lungs! YouTube. https://youtu.be/KqZc1JqArco?si=sEz3d0LdVzKi7akY
make sure to complete the EMS medical director overview in order to complete module 3!
Close
Manage the airway
00:10
Manage the airway
00:10
Manage the airway
00:10
Close
EMT-OS Module 3
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Transcript
EMT Optional Skills Training Course
Module 3: Airway Management
Introduction
Airway management
Adding to your toolbox
Airway management is one of the most critical skills for every level of EMS provider. Ensuring a clear and functional airway can mean the difference between life and death in many emergencies, from trauma and cardiac arrest to medical conditions like anaphylaxis or respiratory failure. This module provides an overview of key airway management concepts, including airway anatomy, respiratory physiology, assessment techniques, basic and EMT-OS interventions, and proper use of equipment.
Module Content
Airway Anatomy & Physiology
Objectives
EMT-OS Airway Skills
BLS Airway Review
Objectives
OBJECTIVES
At the completion of this module, you will be able to:
identify upper and lower airway anatomy
Describe respiratory physiology
Describe indications and contraindications for bls airways
Describe appropriate suction techniques
Describe appropriate ventilation techniques
Describe indications and contraindications for supraglottic airway placement
Demonstrate how to properly size a supraglottic airway for an adult patient
Demonstrate appropriate palcement of supraglottic airway
Idenitfy how to properly monitor airway after supraglottic airway placement
module Topics
MODULE Topics
airway anatomy & physiology
BLS Airway review
EMT-OS Airway skills
Learn how to measure, insert, and monitor supraglottic airway devices.
Review BLS airways, suction, and ventilation.
Review airway anatomy and physiology.
airway anatomy and physiology
Airway A&P Intro
The airway provides the structure for air to move in and out of the body. This is an essential function that is a key focus of initial EMS care. Maintaining a patent airway is a critical step to all other EMS interventions. In this module, you will review airway anatomy and physiology, and reivew BLS airway management. You will also be introduced to supraglottic airways as part of the EMT-OS scope of practice.
airway anatomy and physiology
upper Airway Anatomy review
Select each icon to review the structures of the upper airway.
airway anatomy and physiology
lower Airway Anatomy review
Select each icon to review the structures of the lower airway.
Make sure to review the airway anatomy diagrams in your workbook.
airway anatomy and physiology
Tour The airway
Watch the video to see a live view of the anatomy of the airway.
Original Video Source: MedicalMavericksTV
airway anatomy and physiology
Click only on the correct components of the upper & lower airway
Lower Airway
Upper Airway
Carina
Nasopharynx
Vallecula
Carina
Alveoli
Epiglottis
Oropharynx
Alveoli
Cricoid cartilage
Trachea
Bronchus
Oropharynx
Esophagus
Trachea
Bronchiole
Pharynx
Check
Check
airway anatomy and physiology
Ventilation vs. Respiration
Watch the video to learn more about the difference between ventilation and respiration.
airway anatomy and physiology
Key takeaways
Understand Airway structures
Ventilation vs. Respiration
The structures of the airway provide protection to the patient in various ways. Anything that moves down into the lower airway can increase the risk of infection for the patient.
Remember that we need to ensure that patients can move air in and out (ventilation), and that they also have good gas exchange (respiration).
bls airway review
BLS airway review
BLS airway skills are the core of all airway skills in EMS. Having a mastery of the basic skills before adding new tools to your toolkit is essential. In this section, you will review BLS airway skills including opening the airway, suctioning, ventilating a patient, placing a BLS airway, and monitoring a patient using ETCO2.
bls airway review
opening the airway
Watch the video to review OPA placement. Then, select the icons below for more OPA tips.
bls airway review
Suction review
Select each image to review the key points of suctioning.
Hard tip suction catheters can be used for large amounts of fluid or vomit. Do not suction further than you can see to avoid stimulating the gag reflex. Soft-tip catheters can be used for pediatrics and to suction ET tubes or suppraglittic airways. Apply suction only on the way out of the mouth and limit suctioning to 10 seconds when possible.
Saline or sterile water can be used to clear the suction catheter if it becomes clogged during suctioning.
Suction units can be powered or manual. If using a powered suction, make sure to check the batteries at the beginning of each shift. Powered suction units should generate 300 mmHg when clamped.
bls airway review
Ventilation review
Hover over each icon to review key points of BVM ventilation.
bls airway review
oropharyngeal airway review
Watch the video to review OPA placement. Then, select the icons below for more OPA tips.
bls airway review
nasopharyngeal airway review
Watch the video to review NPA placement. Then, select the icons below for more NPA tips.
bls airway review
Scenario
Read the scenario, then select the button below to manage the airway. Once the window opens, you will have 10 seconds to select the items you will need to manage this patient's airway.
You arrive on scene to find a 58 y/o female unresponsive on the couch. She has a faint, slow pulse, but is apneic and cyonotic around her lips. Your crew moves her to the ground and you are directed to manage her airway. When you open the airway with a head-tilt, chin lift, there does not appear to be any obstructions.
Manage the Airway
bls airway review
Scenario
Read the scenario, then select the button below to manage the airway. Once the window opens, you will have 10 seconds to select the items you will need to manage this patient's airway.
You arrive on scene to find a 72 y/o female with chest pain and shortness of breath. She has one-word dyspnea and has been coughing up pink sputum. Her SpO2 is 78%.
Manage the Airway
bls airway review
Scenario
Read the scenario, then select the button below to manage the airway. Once the window opens, you will have 10 seconds to select the items you will need to manage this patient's airway.
You arrive on scene to find a 40 y/o male on the kitchen floor. He is semi-conscious and groans to painful stimuli. His breathing is slow and shallow at around 4 breaths per. There is an empty pill bottle on the counter of antidepressant medication that was filled yesterday.
Manage the Airway
bls airway review
ETCO2 Review
Watch the video to learn more about capnography. Hover over the icons below for more ETCO2 tips.
bls airway review
Scenario
You arrive on scene to find a 60 y/o M in cardiac arrest at the pool. Bystanders removed him from the pool and are performing CPR. Your crew takes over and starts compressions and ventilations. Select the capnography to review the patient's initial capnography reading. Then, select the button below to answer Question 1.
Question 1
bls airway review
After 8 minutes of CPR, you see the following ETCO2 reading:
bls airway review
Scenario
You arrive on scene to find a confused 26 y/o M breathing fast and deep. His roommates tell you he is a type 1 diabetic who ran out of insulin and so they tried to give him juice when they noticed he was confused, but it didn't help. His skin is hot and dry and his breath smells like citrus. SpO2 is 96%. Select the capnography to review the patient's capnography reading. Then, select the button below to answer Question 1.
Question 1
emt-os airway skills
emt-os airway skills Intro
EMT-OS adds an additional airway skill to your toolkit that allows you to better protect patient's airways. It is important to understand how to use this new skill correctly. This section will cover the indications and contraindications, sizing, and confirming placement for a supraglottic airway. SBEMSA has approved the i-gel as the supraglottic airway for Santa Barbara County, so this training will focus on the i-gel. Before you start this section, review Policy 533-02 and Policy 546 in your workbook or by clicking the links below.
Policy 533-02
Policy 546
emt-os airway skills
Supraglottic Airways: i-gel
Click the icons to learn more about the benefits of using a supraglottic airway.
Relatively easy to insert
Less fatigue to providers
Lowers aspiration risk (if placed correctly)
May relieve anatomical obstruction
emt-os airway skills
deciding to use an i-gel
select each card to learn when placing an i-gel is appropriate
Contraindications
Indications
Indications
Contraindications
emt-os airway skills
i-gel sizing
once you decide you need to place an airway, size it appropriately
Using an appropriate sized airway is important for every airway we use in EMS. Supraglottic airways, especially the i-gel, need to be properly sized so they seat correctly over the glottic opening to protect the airway. Remember that EMT-OS providers can only place supraglottic airways for adult patients!
bls airway review
Size the airway
You arrive on scene to find a 17 y/o female in respiratory arrest after taking a bottle of tylenol. She has a weak pulse. Your crew is ventilating the patient while you set up to place an i-gel. The patient weighs 77 pounds.
bls airway review
Size the airway
You arrive on scene to find a 32 y/o male in cardiac arrest. Your crew suctions and is ventilating the patient while you set up to place an i-gel. The patient weighs 450 pounds.
emt-os airway skills
Placing the i-gel
Scroll through the images to see the steps to placing an i-gel. Remember to have suction, a stethoscope, capnography, and the BVM prepared prior to placing the i-gel.
emt-os airway skills
PLace the I-gel
Watch the video to see an example of placing an i-gel on a cadaver.
emt-os airway skills
Verify i-gel placement
select the icons to learn more about how to verify i-gel placement
bls airway review
Scenario
1 of 6
Read the scenario, then answer each question to managing his airway.
You arrive on scene to find a 46 y/o male on the ground after falling from the roof of a building. He is unconscious and has agonal breathing. There is bleeding to his head and mouth.
bls airway review
Scenario
2 of 6
You arrive on scene to find a 46 y/o male on the ground after falling from the roof of a building. He is unconscious and has agonal breathing. There is bleeding to his head and mouth. After opening the airway, you notice blood in the airway, but the patient does not gag.
bls airway review
Scenario
3 of 6
You arrive on scene to find a 46 y/o male on the ground after falling from the roof of a building. He is unconscious and has agonal breathing. There is bleeding to his head and mouth. You have now cleared the airway and are deciding how to begin ventilating the patient.
bls airway review
Scenario
4 of 6
bls airway review
Scenario
5 of 6
bls airway review
Scenario
6 of 6
county policies
Module 3 completion and study
review the following policies online or in your workbook
Policy 533-02
Policy 546
Airway Management
Supraglottic Airway Device
Note: you must complete the ems medical director overview of i-Gel for Expanded Scope in order to complete module 3!
References
MOdule references
Alexander, M., & Belle, R. (2016). Advanced EMT: A clinical reasoning approach (2nd ed.). Pearson Education. Limmer, D., O'Keefe, M., & Dickinson, E. T. (2020). Emergency care (14th ed.). Pearson Education. Scanlon, V. C., & Sanders, T. (2015). Essentials of anatomy and physiology (7th ed.). F. A. Davis Walls, R. M., & Murphy, M. F. (Eds.). (2012). Manual of emergency airway management (4th ed.). Wolters Kluwer / Lippincott Williams & Wilkins. ResusMonitor. (n.d.). ResusMonitor: Simulation patient vitals monitor [Web application]. Retrieved July 8, 2025, from https://resusmonitor.com/ Intersurgical Inc. (n.d.). i‑gel® O₂ Resus Pack. Intersurgical Inc. Retrieved July 8, 2025, from https://www.intersurgicalinc.com/products/airway-management/i-gel-o-resus-pack MedicalMavericksTV. (2012, April 4). Broncoscopy Procedure - See inside the lungs! YouTube. https://youtu.be/KqZc1JqArco?si=sEz3d0LdVzKi7akY
make sure to complete the EMS medical director overview in order to complete module 3!
Close
Manage the airway
00:10
Manage the airway
00:10
Manage the airway
00:10
Close