Airway assessment and management is usually the first priority in trauma. The patient's airway may become obstructed from bleeding, edema, emesis or foreign bodies. If the patient has TBI or a depressed mental status, they may lose their their protective airway reflexes. If the patient is alert, they should be able to cry or talk without difficulty. If the patient is unresponsive, look, listen and feel for air movement and breathing and determine if there is an airway obstruction. Signs of an airway obstruction include snoring due to soft tissue or tongue obstruction of the naso- or oropharynx; gurgling due to blood or emesis in the airway; stridor from edema or narrowing at or near the level of the vocal cords; and hoarseness due to laryngeal trauma or burns.

If the patient is not breathing, as an adequate respiratory effort, or signs of airway obstruction, immediate airway management is indicated. Position the airway maintaining in-line cervical stabilization using the modified jaw thrust technique. Suction if needed. Assist ventilations or use an airway adjunct as indicated.