Trauma Nurse Core Course (TNCC) Practice Exam

During the primary survey of an unconscious trauma patient, what should be done next if snoring respirations are noted?

1. Open the airway with the head-tilt/chin lift maneuver

2. Auscultate bilateral breath sounds to assess ventilatory status

3. Assist respirations using a BVM

4. Insert an oropharyngeal airway if there is no gag reflex

The correct answer is: Insert an oropharyngeal airway if there is no gag reflex

When encountering snoring respirations in an unconscious trauma patient, inserting an oropharyngeal airway is the most appropriate action if there is no gag reflex. Snoring respirations often indicate airway obstruction, typically due to the tongue falling back and occluding the airway. The oropharyngeal airway helps to displace the tongue anteriorly, thus maintaining an open airway and improving ventilation. This intervention is particularly critical in unconscious patients who may lack the protective reflexes to prevent airway obstruction. The absence of the gag reflex further supports the need for this intervention, as it indicates a significant risk for airway compromise and aspiration. By ensuring the airway is clear and supported with the oropharyngeal airway, you provide the best chance for adequate oxygenation and ventilation. Other maneuvers, such as the head-tilt/chin lift, while useful in many scenarios, may not sufficiently address the obstruction caused by the tongue in an unconscious individual. Likewise, auscultating breath sounds could be relevant later in the assessment but does not directly resolve the immediate airway issue presented by snoring. Assisting respirations with a bag-valve-mask (BVM) could be necessary in subsequent steps, but it requires an adequate airway to be effective,