What is a concern in the airway management of elderly patients?

• A. The nasal airway should always be used in elderly patients
• B. The time to perform airway management increases risk of confusion
• C. The oropharyngeal airway should never be used in elderly patients
• D. The jaw thrust maneuver may need to be used more often because of the higher risk of spinal injury

Answer: (D)

In older adults, protecting the cervical spine during airway management is crucial because degenerative changes and osteoporosis raise the risk of spinal injury with trauma. The jaw thrust opens the airway without extending or rotating the neck, allowing you to keep the head in a neutral position and maintain inline stabilization. Because elderly patients may have cervical spine disease or occult injuries, you’re more likely to need this maneuver to secure the airway while minimizing spinal movement.

The other statements aren’t as universally applicable. A nasal airway isn’t always appropriate in older patients due to facial trauma, epistaxis, or anticoagulation risks. An oropharyngeal airway isn’t banned in the elderly; it’s used in unconscious patients without a gag reflex, but isn’t a blanket rule. While rapid airway management is important, the key safe practice highlighted here is safeguarding the spine during airway maneuvers.