UNCONTROLLED WHEN PRINTED
Indications
- Essntial techniques to open and maintain a patent airway in patients without reflexes.
- The lateral position is a form of essential airway management in the unconscious patient who is breathing adequately.
Contraindications
Contraindications
Patient Factors & Considerations
- Leave dentures in place if well-fitting but if loose and likely to become an airway threat, then gently remove (keep safe and accounted for).
- Double airway manoeuvre (jaw thrust / open mouth without head tilt) should be utilised in suspected spinal injury.
Procedure
- Position the patient with appropriate padding in place as follows:
| Infant | Head and neck in neutral position with padding under shoulders. |
|---|---|
| Child | Head and neck in neutral position with padding under shoulders. |
| Adult | Head and neck in neutral position with padding under head. |
| Obese | Increase the head elevation to align the airway passages. |
- Inspect the airway using the cross finger method.
- Check for visible obstructions and remove if possible using principles in the Foreign Body Airway Obstruction and/or Direct Laryngoscopy/ Magill Forceps Clinical Skill.
Cross-finger technique
- Ensure gloves are worn when performing this procedure
- Place thumb on the patient's lower teeth and index finger on the upper teeth
- Gently open the mouth by pushing teeth apart[1].
Double-airway manoeuvre
In suspected spinal injury (if the patient has sustained head, neck, or spine trauma), open the airway using the double-airway manoeuvre
- Jaw Thrust: Ensuring the neck remains in an anatomically neutral position, place manual pressure at the angle of the mandible (jaw) and lift the jaw anteriorly. This will lift the tongue and minimise obstruction to the airway[2].
- Open Mouth: Utilise both thumb tips to push the chin forwards to open the mouth and visualise the oropharynx[3].
Triple-airway manoeuvre
- Head Tilt: Use both hands on side of head to tilt head backwards.
- Jaw Thrust: Place manual pressure at the angle of the mandible (jaw); lift the jaw anteriorly. This will lift the tongue and minimise obstruction to the airway.
- Open Mouth: Utilise both thumb tips to push the chin forwards to open the mouth and visualise the oropharynx[4].
- Cross-finger technique:
- Jaw thrust:
- Double-airway manoeuvre:
- Triple-airway manoeuvre:
Success
Success
Discontinue
Discontinue
Additional Information
References
- Triple Airway Manoeuvre. (2014). Expert in My Pocket. http://expertinmypocket.com.au/triple-airway-manoeuvre/
Document Control
Directorate
Clinical Services
Responsible Manager
Head of Clinical Services
Published Date
Review Date
St John Ambulance Western Australia Ltd © Copyright 2020, All Rights Reserved