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Manual Airway Maneuvers

Airway obstruction in unconscious patients may be due to posterior displacement of the tongue; however, research in obstructive sleep apnea and CPAP shows that the concept of the airway collapsing like a flexible tube may be more accurate[4,9] (Fig. 3–1A). Upper airway obstruction may cause snoring or stridor, but an apneic patient or one who is moving minimal air may not exhibit any audible evidence of upper airway obstruction. Therefore, every unconscious patient has a potential upper airway obstruction.

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More than 30 years ago, Guildner[10] compared different techniques for opening obstructed upper airways and found that the head-tilt/chin-lift and the jaw-thrust techniques were effective (see Fig. 3–1B and C). Modern airway textbooks still describe the head-tilt/chin-lift and the jaw-thrust maneuvers, but also describe the “triple airway maneuver,” which is a combination of head-tilt, jaw-thrust, and mouth opening.[4,11]

It is widely accepted that the jaw-thrust-only …