Which action best indicates airway patency in a patient with an airway device?

• A. Having the patient speak, watching the chest rise and fall, or both
• B. Endotracheal tube size and position
• C. Oxygen saturation monitoring
• D. Auscultation of breath sounds

Answer: (A)

Airway patency means air is moving through the airway and reaching the lungs. The clearest bedside evidence of that in a patient with an airway device is the ability to produce speech and observable chest movement. If the patient can speak or vocalize, air is passing through the airway and around the device as needed; and watching the chest rise and fall confirms that air is being ventilated into the lungs with each breath. Oxygen saturation shows how well blood is being oxygenated but doesn’t directly prove the airway is open or ventilating. Auscultating breath sounds provides another check, but it can be unreliable in a noisy environment or with devices in place. Endotracheal tube size and position are important for placement, not a direct real-time measure of patency. So the best indicator of an open, patent airway is the patient’s ability to speak plus visible chest movement, or either of those signals.