Opening an airway is a fundamental emergency procedure that involves clearing and maintaining a clear passage for air to enter and exit the lungs. This intervention is often performed when an individual is unconscious and unable to breathe effectively on their own. Establishing an open airway is a crucial initial step in emergency care, directly impacting the delivery of oxygen to the brain and other vital organs, which can be immediately life-saving.
Why Airway Opening is Essential
When a person becomes unconscious, the muscles throughout their body relax, including those in the jaw and throat. This relaxation can cause the tongue to fall backward and obstruct the pharynx, blocking the airway. Other soft tissues can also contribute to this obstruction. An open airway is essential for continuous breathing and efficient oxygen delivery to the brain and body tissues. Without adequate oxygen, brain damage can begin within minutes, underscoring the urgency of this action.
The Head-Tilt, Chin-Lift Technique
The head-tilt, chin-lift maneuver is a common method for opening an airway when there is no suspicion of a spinal injury. This technique helps move the tongue away from the back of the throat, creating an unobstructed pathway for air.
To perform this, ensure the person is lying on their back on a firm surface. Kneel beside their head.
Place the palm of one hand on the person’s forehead and apply gentle, firm pressure to tilt their head backward. This movement extends the neck and aligns the airway. Simultaneously, place the fingertips of your other hand under the bony part of the person’s chin. Gently lift the chin upward and forward, which helps move the tongue away from the posterior pharynx.
Avoid pressing on the soft tissues under the chin, as this could inadvertently obstruct the airway further. The goal is to lift the jaw to align the oral and pharyngeal axes, allowing air to flow freely. After performing the maneuver, observe the person’s chest for visible rise and fall, listen for breath sounds, and feel for exhaled air to confirm an open airway and effective breathing.
The Jaw-Thrust Maneuver
The jaw-thrust maneuver is an alternative technique used to open the airway, specifically when a spinal injury is suspected. This method minimizes neck movement, which is important to prevent further spinal cord damage.
To begin, position yourself at the top of the person’s head, kneeling. Place your index and middle fingers under the angles of the person’s lower jaw on both sides. Your thumbs should rest on their cheekbones or just below their lower lip for support.
Using your fingers, gently lift the jaw upward and forward without tilting the head or extending the neck. This action pulls the tongue away from the back of the throat, clearing the airway. This technique is more challenging to master than the head-tilt, chin-lift, but it is essential for situations where neck stability is a concern.
Critical Safety and Procedural Considerations
Before attempting any airway opening maneuver, always ensure the scene is safe for both yourself and the unconscious person. Once the scene is secure, immediately call for emergency medical help, such as 911 or your local emergency number.
After opening the airway, check for breathing. Look for chest rise, listen for normal breath sounds, and feel for the flow of air. If the person is not breathing normally or is only gasping, initiate cardiopulmonary resuscitation (CPR) if trained.
Continuous assessment of the person’s breathing and responsiveness is necessary. If the person begins breathing normally, placing them in a recovery position can help maintain the open airway and prevent aspiration. These maneuvers should only be performed on unconscious individuals; if conscious and breathing normally, these interventions are not necessary.