Managing a completely or partially obstructed airway
Those with a completely or partially obstructed airway need the rescuer to attempt to open the airway for them. There are two well described techniques for this.
1. Jaw thrust
The tongue is firmly attached to the jaw bone. So, if the airway is obstructed, lifting the jaw forwards will pull the tongue forwards and away from the back of the throat - allowing the free passage of air in and out. This is known as the jaw thrust procedure. This is the technique of choice for opening the airway in any head or neck injury as it causes very little movement of the neck.
The jaw thrust procedure for opening the airway
Opening the airway with the jaw thrust procedure
- Kneel at the head end of the casualty supporting the head with MILS (see later).
- Place both thumbs on the casualty’s cheek bones.
- Place the index and middle fingers behind the angle of the jawbone.
- Gently lift the jaw forward – ensuring minimal movement of the head and neck.
- Reassess the patient for airway sounds.
- If you let go, the airway will close.
2. Head tilt / chin lift
Another technique for opening the airway exists and is known as the head tilt / chin lift and relies on the position of the tongue relative to the throat. Tilting the head backwards and lifting the chin forwards effectively moves the tongue forwards away from the back of the throat and opens the airway. However, it involves significant movement of the neck and so is not recommended in a head or neck injury in a Rugby setting.
Head tilt / chin lift manoeuvre to open airway (do not use if there is a head or neck injury)
Opening the airway. Head tilt / chin lift (not if you suspect a head or neck injury)
- Kneel at the side of the casualty’s head and neck.
- Place one hand across the forehead of the casualty.
- Put two fingers of the other hand under the chin.
- Lift the chin forwards whilst stabilising the forehead – so tilting the head backwards.
- Look in the mouth and assess the airway noises.
Putting fingers into the mouth to grab the slippery tongue will not help open the airway and may make it worse. Do not do it! Download the World Rugby First Aid in Rugby skill cards in Adobe PDF format