Jaw thrust is a technique to protect the airway of a patient with a potential spinal injury. It is recommended that only trained emergency services personnel and physicians perform the jaw thrust as it is potentially dangerous to the patient. The technique involves pulling the jaw forward to keep the throat clear. Other options include the head tilt and chin lift technique. In anesthesiology, a healthcare provider may consider using a jaw thrust to keep the tongue out of the airway during surgery. The technique should only be considered if a patient has difficulty breathing or appears not to be breathing at all.
A jaw thrust is a technique to protect the airway of a patient who may have a spinal injury; in such cases, healthcare providers want to avoid moving the head and neck, but still need to make sure the patient can breathe. Historically, this technique was widely taught, but over time, doctors have come to recommend that only trained emergency services personnel and physicians perform the jaw, as it is potentially dangerous to the patient. It can be used in the field and in environments such as operating rooms to keep a patient’s throat clear.
In a jaw thrust, the patient is supine, lying face up. The doctor places his hands on either side of the face, hooking the fingers under the tip of the jaw, just below the ear. Next, the person pulls the jaw forward. This moves the jaw, also pushing the tongue forward, and keeps the throat clear. Otherwise, the tongue may fall back into the throat, blocking the patient’s airway and making breathing difficult.
A patient with a potential spinal cord injury is cause for concern. Moving the head and neck could exacerbate the injury and cause further damage. If the patient cannot breathe, however, the outlook is extremely bleak. Techniques such as jaw propulsion allow healthcare professionals to provide basic care with minimal risk to their patients. Other options include the head tilt and chin lift technique, widely taught in cardiopulmonary resuscitation classes so people know how to quickly open a patient’s airway in a reasonably safe way.
In anesthesiology, a healthcare provider may consider using a jaw thrust on a patient to keep the tongue out of the airway during surgery, depending on the situation and personal preference. Anesthesiologists must manage the airways carefully, as their patients cannot breathe on their own and may be at risk of complications if they are not getting enough air. Having a library of methods for opening the airways and keeping them clear is useful for a variety of situations.
In a patient who can breathe independently, mandibular thrust is unnecessary. Maneuvers to open the airways should only be considered if a patient has difficulty breathing or appears not to be breathing at all. The simple step of asking the patient questions and waiting for an answer can determine if the airway is clear; if the patient is talking, she can breathe.
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