The jaw-thrust maneuver is a first aid and medical procedure used to prevent the tongue from obstructing the upper airways. This maneuver and the head-tilt/chin-lift maneuver are two of the main tools of basic airway management, and they are often used in conjunction with other basic airway techniques including bag-valve-mask ventilation. The jaw-thrust maneuver is often used on patients with cervical neck problems or suspected cervical spine injury.
The maneuver is used on a supine patient. It is performed by placing the index and middle fingers to physically push the posterior aspects of the lower jaw upwards while their thumbs push down on the chin to open the mouth. When the mandible is displaced forward, it pulls the tongue forward and prevents it from obstructing the entrance to the trachea.
Traditionally, the jaw-thrust maneuver has been considered the better alternative (rather than the head-tilt/chin-lift maneuver) when a first aider suspects that the patient may have a spinal injury (especially one to the neck portion of the spine). The International Liaison Committee on Resuscitation has reviewed various studies that found no spine-protecting advantage to the jaw-thrust maneuver. Its "Treatment Recommendation" under "Opening the Airway" says, "Rescuers should open the airway using the head tilt–chin lift maneuver." If the patient is in danger of pulmonary aspiration, he or she should be placed in the recovery position, or advanced airway management should be used.
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In first aid, the recovery position (also called semi-prone) is one of a series of variations on a lateral recumbent or three-quarters prone position of the body, often used for unconscious but breathing casualties. An unconscious person, a person who is assessed on the Glasgow Coma Scale (GCS) at eight or below, in a supine position (on the back) may not be able to maintain an open airway as a conscious person would. This can lead to an obstruction of the airway, restricting the flow of air and preventing gaseous exchange, which then causes hypoxia, which is life-threatening.
The head-tilt/chin-lift is a procedure used to prevent the tongue obstructing the upper airways. The maneuver is performed by tilting the head backwards in unconscious patients, often by applying pressure to the forehead and the chin. The maneuver is used in any patient in whom cervical spine injury is not a concern and is taught on most first aid courses as the standard way of clearing an airway. This maneuver and the jaw-thrust maneuver are two of the main tools of basic airway management.
Advanced airway management is the subset of airway management that involves advanced training, skill, and invasiveness. It encompasses various techniques performed to create an open or patent airway – a clear path between a patient's lungs and the outside world. This is accomplished by clearing or preventing obstructions of airways. Obstructions can be caused by many things, including the patient's own tongue or other anatomical components of the airway, foreign bodies, excessive amounts of blood and body fluids, or aspiration of food particles.