ACLS Provider: Course

Head-Tilt/Chin-Lift Maneuver

The head-tilt/chin-lift maneuver is one of the most essential airway-opening techniques used during resuscitation. It is primarily performed in unresponsive patients without a suspected cervical spine injury. This maneuver helps to open the airway by preventing the tongue from obstructing the oropharynx and is commonly the first technique used in basic airway management.

When to Use the Head-Tilt/Chin-Lift

This maneuver is indicated in any unresponsive patient without signs of trauma who needs airway support. It’s commonly used in cardiac arrest, overdose, and other causes of unconsciousness.

  • Unconscious patient without suspected cervical spine injury.
  • Initial step in airway management during BLS or ACLS.
  • Required when using a bag-valve-mask (BVM) for ventilations.

When NOT to Use It

Avoid the head-tilt/chin-lift if there is any suspicion of cervical spine injury. In trauma patients, a jaw-thrust should be used instead to protect the spinal cord.

How to Perform the Head-Tilt/Chin-Lift

  1. Place the patient supine on a firm, flat surface.
  2. Position yourself beside the patient’s head.
  3. Place one hand on the forehead and apply gentle pressure to tilt the head back into slight extension.
  4. With the fingertips of your other hand, gently lift the chin upward by applying pressure to the bony part of the lower jaw.
  5. Keep the mouth slightly open and avoid pressing on the soft tissue under the chin, which can further obstruct the airway.

This positioning lifts the tongue away from the posterior pharynx and helps restore airway patency.

Common Errors and How to Avoid Them

  • Pressing on soft tissues: Can worsen obstruction — always lift from the bony chin.
  • Inadequate head tilt: May leave the airway partially blocked — ensure full extension unless contraindicated.
  • Insufficient chin lift: May allow the tongue to fall back — lift firmly to open the airway fully.

Why This Skill Matters

Airway obstruction from the tongue is common in unconscious patients. Mastering the head-tilt/chin-lift maneuver ensures rapid airway clearance in patients without trauma and enables effective ventilation with a BVM. It's a foundational component of basic and advanced resuscitation techniques.