How to Open the Airway During CPR

When performing cardiopulmonary resuscitation (CPR), ensuring an open airway is a critical first step. The human airway follows a path that first runs vertically and then curves forward and upward. To properly open the airway, the head should be tilted back, aligning the upper and lower sections of the airway into a straight line. This allows for improved airflow and easier breathing. There are several effective techniques used to open the airway during CPR, each suited for different situations.

1. Head Tilt-Chin Lift Maneuver

One of the most commonly used methods is the head tilt-chin lift technique. In this approach, one hand is placed on the victim's forehead to gently tilt the head backward, while the other hand is used to lift the chin. By lifting the chin (specifically the area beneath it), the jaw is moved forward, which helps open the airway by aligning it into a straighter position. This method is especially effective when there is no suspicion of spinal injury.

2. Head Tilt-Neck Lift Maneuver

Another similar technique is the head tilt-neck lift method. Here, one hand is used to press down gently on the forehead while the other hand supports the neck from below, lifting it slightly to extend the head backward. This positioning helps align the airway and ensures it remains open. Like the head tilt-chin lift, this method should only be used when there is no concern about cervical spine damage.

3. Jaw-Thrust Maneuver for Suspected Neck Injuries

Why It's Different

In situations where a cervical spine injury is suspected, the previous two methods may not be safe. Instead, the jaw-thrust maneuver is recommended. This technique involves placing the index and middle fingers behind the angle of the jaw while using the thumbs to gently push forward on the lower jaw. This action lifts the jaw without moving the neck, thereby opening the airway safely.

Effectiveness and Considerations

While the jaw-thrust method is safer for individuals with potential spinal injuries, it may not be as effective in fully opening the airway compared to the head tilt techniques. Therefore, if there is no evidence of neck trauma, the head tilt-chin lift or head tilt-neck lift methods are preferred for their simplicity and reliability.

Mastering these airway-opening techniques is essential for effective CPR. Proper training and practice can help rescuers choose the best method based on the victim's condition and any potential injuries.