Partially obstructed airways with blood or vomit

The only effective way to remove liquids from the back of the throat is to turn the casualty on to their side to allow it to drain away with gravity. As injured players with an obstructed airway will almost certainly die unless you open it, airway takes absolute priority over any potential neck injury.

Hence, you should not delay in rolling the player over onto their side if the airway is gurgling due to witnessed blood or vomit. If this liquid travels further down into the lungs, it will cause further problems with breathing at a later stage.

Ideally, any attempt to roll the casualty should involve up to four people, but a lone rescuer can position the casualty on their side to allow liquid to drain away or even use the HAINES (High Arm In Endangered Spine) manoeuvre. This is a modification of the traditional roll and recovery position manoeuvre that produces less sideways bending of the neck. It can be found in more detail in the spinal injuries chapter.

Once the airway has been opened, A of the DR ABC has been addressed and the rescuer can then make a more detailed assessment of B - Breathing.

Emergency roll with HAINES manoeuvre for vomit that is obstructing airway

Skill 3

HAINES style emergency roll manoeuvre

  1. Place the player’s nearest hand on their chest.
  2. Raise the player’s opposite arm alongside their head.
  3. Place your hand under the player’s head.
  4. Place your second hand on the player’s nearest shoulder / upper arm.
  5. Supporting the head, roll the casualty away from you and tilt the head back.
  6. Allow liquid to drain away with gravity.
  7. Return to original position.
  8. Reassess airway.
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