JAW-THRUST MANEUVER

 

The jaw-thrust maneuver is a critical airway-opening technique used when cervical spine injury is suspected. Unlike the head-tilt/chin-lift maneuver, the jaw-thrust does not require neck movement, reducing the risk of worsening spinal cord injury.

🚨 Why It’s Important:
✅ Safely opens the airway without moving the neck.
✅ Prevents further spinal injury in trauma patients.
✅ Effective for airway management in unconscious trauma victims.

 

1️⃣ HOW THE JAW-THRUST WORKS

🫁 In unresponsive patients, the tongue can fall back and block the airway.
🔹 The jaw-thrust maneuver lifts the jaw forward, pulling the tongue away from the airway without tilting the head.

🚨 This maneuver is the preferred method for airway management in trauma patients!

 

2️⃣ INDICATIONS FOR THE JAW-THRUST MANEUVER

✅ Unresponsive patient needing airway support.
✅ Suspected cervical spine injury (e.g., motor vehicle accidents, falls, head trauma).
✅ Patients requiring airway opening without neck movement.

🚑 This maneuver is commonly used in trauma resuscitation and spinal injury scenarios.

 

3️⃣ CONTRAINDICATIONS

❌ Conscious patients

  • The maneuver is uncomfortable and unnecessary in an awake patient.

❌ Severe jaw or facial trauma

  • If the mandible is fractured or dislocated, alternative airway techniques may be needed.

🚨 If the patient is conscious or resisting, reassess the need for airway intervention!

 

4️⃣ TECHNIQUE: HOW TO PERFORM THE JAW-THRUST MANEUVER

✅ Step-by-Step Instructions:

1️⃣ Positioning the Patient:

  • Place the patient supine (on their back) on a firm, flat surface.

2️⃣ Hand Placement:

  • Position yourself at the head of the patient.
  • Place both hands on either side of the patient’s head.
  • Place the index and middle fingers behind the angles of the mandible (just below the earlobes).

3️⃣ Lifting the Jaw:

  • Using your fingers, push the lower jaw forward and upward (toward the ceiling).
  • The mandible should move forward enough to open the airway and prevent the tongue from obstructing it.

4️⃣ Maintaining the Position:

  • Keep holding the jaw forward while assessing breathing or assisting ventilation.

🚨 Key Tip: If using a bag-valve-mask (BVM), a second rescuer may be needed to provide effective ventilations while maintaining the jaw-thrust.

5️⃣ IMPORTANT CONSIDERATIONS

🔹 Avoid Any Head Tilt – The goal is to protect the cervical spine.
🔹 Requires More Force Than Head-Tilt/Chin-Lift – This maneuver is physically demanding and may cause rescuer fatigue.
🔹 May Require Two Rescuers – One to hold the jaw-thrust and another to provide ventilations with a BVM.
🔹 If the airway remains obstructed, consider additional airway adjuncts (e.g., oropharyngeal airway [OPA] or nasopharyngeal airway [NPA]).

🚨 If the jaw-thrust alone is ineffective, a slight head tilt may be needed in non-high-risk spinal injury cases.

 

6️⃣ COMPARISON: JAW-THRUST VS. HEAD-TILT/CHIN-LIFT

 

FeatureJaw-Thrust ManeuverHead-Tilt/Chin-Lift Maneuver
Preferred ForTrauma patients, suspected cervical spine injuryNon-trauma patients needing airway support
Neck Movement?No (spine remains neutral)Yes (head tilts back)
Ease of UseMore difficult, requires more forceEasier to perform
Requires Two Rescuers?Often, especially when using BVMUsually not

🚨 Use the jaw-thrust maneuver in trauma patients and the head-tilt/chin-lift in non-trauma cases!

 

7️⃣ COMMON ERRORS & HOW TO AVOID THEM

 
ErrorImpactCorrection
Tilting the head back during jaw-thrustPotential spinal injuryKeep the head neutral, only move the jaw
Not applying enough force to lift the jawAirway remains obstructedUse firm pressure behind the mandible
Fatigue leading to ineffective maneuverPoor airway patencySwitch rescuers if needed for prolonged resuscitation

🚨 Mastering the jaw-thrust technique is crucial for safe airway management in trauma patients!

 

8️⃣ WHY THE JAW-THRUST IS A CRITICAL SKILL

✅ It is the safest airway-opening technique for trauma patients.
✅ Prevents further cervical spine injury in high-risk patients.
✅ Is often the first airway maneuver used in trauma resuscitation.
✅ Essential for effective ventilation in spinal-injured patients.

🚑 Takeaway: Mastering the jaw-thrust maneuver ensures that trauma patients receive safe and effective airway support while protecting the cervical spine.