11.3 Airway, Breathing, Circulation, and Medical Emergencies

Recognition, Basic Intervention, and Referral

BPOC 40.7 matches the airway method to the casualty's condition. A conscious person who can protect their own airway may simply assume a position of comfort. An unconscious person with no suspected neck or spine injury gets a head-tilt, chin-lift. An unconscious person with possible neck or spine injury gets a jaw thrust while the head and neck are held neutral, so the airway opens without flexing the cervical spine. The curriculum prohibits blind finger sweeps because they can push an object deeper or be bitten; look first, and clear visible obstructions only.

BPOC 40.8 addresses breathing emergencies. A penetrating wound to the chest, back, or upper abdomen can require an occlusive dressing, preferably a commercial vented chest seal, while monitoring for tension pneumothorax (worsening distress, distended neck veins, tracheal shift). Severe allergic reaction (anaphylaxis), asthma attack, and opioid overdose all demand rapid referral to medical personnel; within authorization, the officer may assist self-administration of a prescribed epinephrine auto-injector or rescue inhaler, and may administer naloxone when indicated, available, and authorized by agency protocol.

Circulation and Condition-Specific Recognition

BPOC 40.9 requires completion of a nationally accredited CPR/AED course covering adults, children, and infants, plus choking and rescue-breathing components. The JTA lists AED deployment, CPR, rescue breathing, first aid for heart attack, and overdose response as core tasks. A cardiac-arrest stem should never be answered with 'transport first' if CPR/AED is immediately indicated and the scene is safe — early defibrillation drives survival. BPOC 40.9 also defines physiological shock as inadequate blood flow producing altered consciousness; pale, cool, clammy skin; and a rapid, weak, or absent pulse.

BPOC 40.10 through 40.14 add environmental, trauma, and metabolic recognition. Heat emergencies: remove from heat and actively cool. Cold emergencies: provide warmth, remove wet clothing, and keep trauma patients warm to prevent the lethal hypothermia link in MARCH. Burns: stop the burning process without exposing the officer, remove constricting jewelry and clothing, cover with dry dressings, and refer. Fractures and severe sprains: immobilize the joint above and below the injury and reassess circulation distal to the splint.

Applied Scenario Guidance

For altered mental status, read the skin. A common BPOC memory aid is 'cool and clammy, give them candy' (suggesting hypoglycemia / low blood sugar) versus 'hot and dry, sugar high.' A seizure stem rewards protecting the person from injury and not holding them down or placing anything in the mouth, then medical referral even if the seizure stops. A childbirth stem rewards calmly supporting a normal delivery but escalating to rapid medical referral for abnormal presentation (breech, prolapsed cord) or heavy bleeding.

Stroke, Diabetic, and Childbirth Specifics

For a suspected stroke, the exam rewards two moves the public often skips: establishing and noting the time of symptom onset (or last-known-well time), because emergency stroke treatment is time-sensitive, and protecting the airway of a person with facial droop and slurred speech who may not swallow safely. Do not give a stroke patient food or drink. A common BPOC field screen is the cincinnati-style check — facial droop, arm drift, and abnormal speech — but the officer's job is recognition and rapid referral, not a clinical diagnosis.

For diabetic emergencies, a conscious person who can swallow may be assisted in taking sugar (the 'cool and clammy, give them candy' aid for low blood sugar), but an unconscious or seizing person must never be given anything by mouth — aspiration risk. For childbirth, support a normal delivery: do not pull the baby, do not delay an imminent birth, keep mother and newborn warm, and escalate immediately for breech presentation, a prolapsed cord, or heavy bleeding. These are recognition-and-support tasks, with rapid EMS referral the constant.

Choking is its own tested skill. For a conscious adult or child who cannot speak, cough, or breathe, the officer delivers abdominal thrusts (the Heimlich maneuver) until the object clears or the person becomes unresponsive; for an infant, the technique is back blows and chest thrusts, never abdominal thrusts. If the choking person becomes unresponsive, begin CPR and look in the mouth before breaths to remove a visible object — but still no blind finger sweep. These adult-child-infant distinctions are exactly the kind of detail a multiple-choice stem uses to separate a memorized procedure from a guess.

Exam Trap

Do not inflate recognition aids into treatment authority. The official pattern is basic aid, airway maintenance, supporting prescribed self-medication when appropriate, authorized naloxone, CPR/AED, and rapid referral — not diagnosing or dosing beyond protocol. Two recurring distractors: treating physiological shock as mere emotional upset, and assuming every altered patient is intoxicated. Both ignore the physical signs the source teaches you to read — pale, cool, clammy skin and a rapid weak pulse point to shock, while pinpoint pupils and slow breathing point to opioids.

A third distractor delays naloxone or an epinephrine auto-injector pending a confession or proof of the substance; the source authorizes acting on the clinical signs within protocol, not waiting for an admission.