c. Establishing an Airway. Sometimes an unconscious casualty who is
breathing poorly will resume normal breathing when his head is positioned so that his
airway is reopened. This is especially true when the casualty's tongue has caused the
airway to become blocked. Since the tongue is attached to the lower jaw, repositioning
the jaw forward can lift the tongue away from the back of the throat and reopen the
airway. Two commonly used methods of establishing an airway are the head-tilt/chin-lift
method and the jaw-thrust method. Establishing an airway should take between 3 and
(1) Head-tilt/chin-lift method. This is the preferred method of opening the
casualty's airway if a spinal fracture in the neck region is not suspected. In addition,
loose dentures can be handled easier using the head-tilt/chin-lift method than when
using another method. Procedures for the head-tilt/chin-lift method of establishing an
airway are given here:
(a) Kneel at the side of the casualty's head.
(b) Place the fingertips of one hand under the bony part of his chin.
Place your other hand on his forehead.
(d) Press on his forehead to make the head tilt back while lifting his
chin forward (figure 1-2 A ). Lift until the teeth are almost brought together. The mouth
should not be closed as this could prevent air from entering the casualty's airway. The
thumb is usually not used in lifting the chin. In some cases, the thumb may be used to
depress the casualty's lower lip slightly to keep his mouth open.
(2) Jaw-thrust method. The jaw-thrust method is an effective method to use
in opening the airway. The procedure is as follows:
(a) Kneel beside the casualty.
(b) Rest your elbows on the same surface on which the casualty is
(c) Place your hands on either side of the casualty's head. Grasp the
angles of the casualty's lower jaw.
(d) Lift the casualty's lower jaw forward and tilt his head backward at
the same time (figure 1-2 B).
(e) If you must perform rescue breathing, pull the casualty's lower lip
open with your thumb and close the casualty's nostrils by placing your cheek tightly
against his nostrils.