The jaw thrust maneuver is a technique used in emergency situations to open a person’s airway. It involves lifting the jaw forward without tilting the head or neck. This procedure aims to clear obstructions, particularly when an individual is unconscious. It is considered a basic airway management tool.
Why Jaw Thrust is Used
An obstructed airway can quickly become a life-threatening emergency, preventing oxygen from reaching the brain and other organs. When a person becomes unconscious, the muscles in the throat, including the genioglossus and pharyngeal muscles, can relax. This relaxation allows the tongue and soft tissues at the back of the throat to fall backward, blocking the airway.
The jaw thrust maneuver addresses this by physically lifting the lower jaw (mandible) forward. This action pulls the tongue away from the posterior pharyngeal wall, clearing the obstruction and allowing air to flow freely into the trachea. This technique is used when there is a concern for a spinal injury because it minimizes cervical spine movement, which could worsen an injury. Other airway opening methods, like the head-tilt chin-lift, involve neck extension, making them less suitable.
Key Indicators for Using Jaw Thrust
The jaw thrust maneuver is indicated when an unconscious patient’s airway is obstructed and a spinal injury is suspected or cannot be ruled out. This suspicion often arises from high-impact incidents like motor vehicle accidents, significant falls, diving incidents, or blunt trauma to the head or neck. In these scenarios, maintaining cervical spine alignment is a primary concern to prevent further neurological damage.
When assessing an unconscious patient, if breathing is absent or ineffective, and spinal trauma is indicated, the jaw thrust maneuver becomes the preferred method for airway management. Place fingers under the angles of the jaw and thumbs on the chin to lift the jaw forward. This movement should be directed upward and slightly forward, ensuring the head remains in a neutral position.
When to Choose Alternatives to Jaw Thrust
When there is no suspicion of a spinal injury, the head-tilt chin-lift maneuver is the preferred and simpler method for opening an airway in an unconscious patient. This technique involves tilting the patient’s head backward while lifting the chin, which effectively moves the tongue away from the back of the throat. It is appropriate in medical emergencies where trauma is not a factor, such as a sudden collapse due to a cardiac event or an overdose without a fall.
It is important to quickly assess the situation to determine the most appropriate airway management technique. If a jaw thrust is attempted but proves ineffective or cannot be performed due to anatomical challenges or rescuer fatigue, and there is no suspicion of spinal injury, then the head-tilt chin-lift should be used. The priority remains to establish a patent airway promptly to ensure adequate breathing, while making an informed decision about minimizing potential harm.