Jaw Thrust: Best Suited When a Neck or Spine Injury Is Suspected

Having to deal with a major life threatening emergency is always stressful and it can become even more so if the casualty is suspected of having suffered a neck injury. If the person is unconscious one of the most important things to do is to open their airway so they can breath. The airway may have become blocked by the tongue, simply because all the muscles relax when someone becomes unconscious. In a normal, non-spinal injury situation, the airway would be opened using a head-tilt chin-lift, where you basically tilt the head back and lift up the chin. However, in a potential spinal injury this should be avoided because of the risk of causing further harm to the spine.

Shows 1) a closed airway and 2) how to open the airway in a casualty whom you don't suspect of having a spinal injury.

Any time someone is involved in an accident where they've fallen or have hit their head, a spinal injury should be suspected. This includes car accidents; motorcycle accidents; falling of a ladder or off a roof of a house, slipping on ice and hitting the back of their head; and sport accidents such as those typical of football or hockey.

In such situations, the alternate and safer way of opening a casualty's airway is by doing what is called a jaw-thrust (see below) without a head-tilt. This method relies on the fact that the tongue is attached to the back of the jaw. So when the jaw is lifted the tongue is also moved. And by moving the tongue the airway can be opened with minimal movement to the spine.

Procedure

• Keep the head in the position found as much as possible.
• Use the index fingers of each hand of your hands to grab the jaw bones on either side of the jaw.
• Slide the jaw upwards as if you are giving them a really bad underbite. Their bottom teeth will come forward while their top teeth remain in the same position.
• As you do this the jaw may become dislocated. It does not sound pleasant but sometimes this is necessary in order to lift the jaw high enough to open the airway. Do not worry about it too much as this will heal later on.

How you open the airway using a jaw-thrust.

Once you have the airway open keep your hands in that position. If you let go the airway may close again. Begin by checking for breathing, giving them two breaths if needed, then starting CPR. Ideally, one rescuer will look after the airway will a second rescuer will look after the chest compressions, if needed. Everytime you blow in you will have to perform this method of opening their airway.

Additional Information

• Always check for breathing in the position found first. There is no need to open their airway if the person is already breathing on their own.
• If you are not able to open the airway with just a jaw-thrust then you won't have any choice but to also tilt the head back a little bit until you succeed. It is vital that the airway be opened in order for the person to have a chance at survival.
• Never move a casualty without a really good reason.
• Whenever possible use a rescue breathing barrier, to reduce the chance of disease transmission.
• Always call for advance medical help if someone is unconscious and/or you suspect they have a spinal, neck, or head injury.
• If the person begins to vomit you will have to roll them onto their side regardless of whether or not they have a spinal injury. The reason for this is; if they choke from their vomit they may die from an obstruction.