ACLS Provider: Course

Airway Management Basics

Establishing and maintaining a patent airway is fundamental to Advanced Cardiac Life Support (ACLS). Ensuring an open airway is crucial for effective ventilation (the movement of air into and out of the lungs) and oxygenation (the delivery of oxygen to the blood), both of which are essential for preventing hypoxia (oxygen deficiency) and subsequent organ damage, particularly to the brain.

Two Basic Airway Maneuvers:

Head-Tilt/Chin-Lift Maneuver

This technique is the primary method for opening the airway in patients without suspected cervical spine (neck) injury. It's simple and effective but should be avoided if a spinal injury is suspected due to the risk of exacerbating the injury.

Jaw-Thrust Maneuver

This technique is the preferred method for opening the airway in patients with suspected cervical spine injury. It minimizes movement of the neck, reducing the risk of further spinal cord damage.

Steps for Each Maneuver:

Head-Tilt/Chin-Lift:

  • Place one hand on the patient's forehead and apply firm backward pressure to tilt the head back.
  • Place the fingers of your other hand under the bony part of the chin.
  • Lift the chin forward, bringing the jaw anteriorly. Avoid pressing on the soft tissues under the chin, as this can obstruct the airway.

Jaw-Thrust:

  • Place your fingers behind the angles of the patient’s mandible (lower jaw), one hand on each side of the head.
  • While stabilizing the patient’s head in a neutral, in-line position, forcefully displace the jaw forward.
  • If necessary, use your thumbs to slightly open the patient’s lips to allow for breathing. Avoid tilting the head or rotating the neck.

Why Airway Management Matters:

Basic airway maneuvers are often the first and most critical steps in managing an unresponsive patient. Without a patent airway, oxygen cannot reach the lungs, and carbon dioxide cannot be expelled. This leads to hypoxia, which can rapidly cause irreversible brain damage and death. These simple techniques can quickly and effectively improve oxygen delivery to vital organs, significantly improving the patient's chances of survival. It's important to remember that even if compressions are performed perfectly, they are less effective if oxygenated blood cannot reach the tissues due to an obstructed airway.