Step-by-Step Guide to Master the Jaw Thrust Maneuver

The jaw thrust maneuver is one of the most important airway management techniques rescuers need to perfect. This method allows rescuers to secure and then maintain an open airway in an unconscious person. This method is unique because it limits the movement and potential aggravation of any known or unknown spinal or neck injuries.

Understanding the jaw thrust maneuver enables a rescuer to take immediate action if someone is unconscious, but there is the risk of spinal cord damage. Learning when and how to use it enables you to protect a victim. This method prevents or minimizes the risk of additional spinal cord injury. It is an essential method to learn if you are a healthcare professional or you work with patients who may be at a high risk.

What Is the Jaw Thrust Maneuver?

The jaw thrust maneuver is a component of CPR training. It allows a rescuer to position a person’s airway in an open position, allowing air to move into the lungs while stabilizing and not further worsening the spinal cord.

Rescuers need to choose between the jaw thrust maneuver and the head tilt-chin lift. The jaw thrust method is beneficial when there are any indications of head, neck, or back trauma. Unlike traditional head tilt, this method maintains the stability of the head and positioning of the spine and instead extends the jaw outward to open the airway.

How to Do the Jaw Thrust Maneuver for First Aid

Use the following steps to perform the jaw thrust technique, as the Merck Manual explains. Use this method if the tongue is blocking the airway and the patient is unconscious, and unable to move their head.

1. Position the Patient:

The success of this method is directly dependent on the positioning of the patient.

• The patient must be lying on their back in the supine position.
• They must be on a firm surface.
• Kneel next to the victim’s head and place both hands on the sides of the patient’s face.
• Place your two middle fingers just under the jaw’s angle.

These first steps provide the best level of control and function for the patient. They allow the rescuer to manipulate the jaw and face during the movement.

2. Position Hands on Jaw:

• Place the palms of your hands on the sides of the patient’s cheeks. Keep them close to the corners of the mouth.
• Place the index and middle fingers behind the mandible, near the bony part of the jaw close to the ears.
• Your thumbs should provide stability to this process. You’ll need a firm grip on the mandible, and your fingers must be positioned just right to allow for the proper movement.

3. Lift the Jaw Forward:

In this particular step, you will apply pressure but do so with only the amount of pressure necessary without pulling on the head in any way to allow it to move. Follow these steps:

• Lift the jaw forward gently by applying pressure on the mandible with your fingers located behind the mandible zone. This position enables you to lift the jaw anteriorly forward, allowing for proper movement of just the jaw and not the head.
• At this point, the lower jaw should move outward. This will allow the tongue to move away from the back of the throat, allowing air to enter the area.
• Throughout this process, keep the patient’s head in a neutral pose. Do not tilt the head, turn it, or otherwise move it in any direction.

After completing these steps, check to see if the patient is breathing. Watch for chest movements and listen for sounds. You may also feel airflow coming from the nose or the mouth at this point. If you do not see these factors occurring, adjust the jaw thrust position more so. You may need to apply more pressure to move the jaw forward. Again, do not use force enough to move the patient’s head.

Jaw Thrust Maneuver vs Head Tilt Chin Lift Position

Understanding the jaw thrust maneuver also helps in understanding the head tilt-chin maneuver. This method is very commonly used and considered the ideal choice in situations where there is no suspected head trauma.

In the head tilt chin lift maneuver, you will still open the airway in an unresponsive person. To perform this method, follow these steps:

• Place one hand on the patient’s forehead. The other hand goes under the chin.
• Gently tilt the head back and lift the chin in an upward movement.
• This moves the tongue away from the back of the throat, allowing air to flow into the airway again.

This is a common first step in rescue breathing. If you do not adjust the position of the tongue, there is no way for a person’s lungs to get the oxygen they need.

Comparing this method to the jaw thrust maneuver, you can see the significant adjustment in movement. The head tilt method opens the airway while adjusting the position of the head. That is something you do not want to do in patients who may have spinal cord damage.

When to Use the Jaw Thrust Maneuver

The head tilt method is beneficial in many situations for two reasons. It’s easier to complete and effective in most situations. However, there are situations where you simply should not use this method because of the risk to the spinal column.

If there is any possibility of a neck injury, use the jaw thrust maneuver instead. It is not always possible to tell if a patient has a spinal cord injury. For this reason, it is best to simply assume there is a spinal cord injury if the patient has experienced any type of physical trauma. This includes situations of:

• Car accidents
• Falls
• Assaults
• Other physical injury

If you find someone who is unconscious, and you do not know what caused this, it is best to use the jaw thrust maneuver instead of the head tilt-chin lift maneuver because of the potential it offers. In these situations, your goal is always to maintain spinal stability as a priority.

Additional examples of when to consider the jaw lift movement or tongue jaw lift, as it may be referred to, include:

1. Any suspected neck or spinal injury: 

Falls, trauma, and accidents are the most common causes of cervical spinal alignment problems.

2. A person is unconscious: 

You do not know what happened and, therefore, must establish breathing quickly without causing further, potentially life-threatening movements.

3. Limited neck mobility: 

If a person has limited ability to move their neck, such as due to a physical injury or developmental concern, do not force it. Instead, use the jaw thrust technique to open up the airway without further damage.

4. Facial trauma: 

A person with facial trauma or fractures that would make the head-tilt chine lift method impossible to do may also benefit from the jaw thrust method instead.

If you are not sure if the head tilt chin lift position will cause harm to a person, skip it and use the jaw thrust maneuver instead.

Key Factors to Consider When Using the Jaw Thrust Maneuver

This method of opening the airway is a basic life support skill. If you have not done so yet, obtain a basic life support certification to help you know what to do, how to do so, and when to apply various strategies.

No matter if you use the jaw thrust or head tilt chin lift maneuver, the goal is to open the airway. It allows you to remove material that could cause choking, relieve strangulation or suffocation, and open blocked airways for other reasons. To be effective, you must perform it properly. For those reasons, consider these helpful, supportive tips:

Ensure a Thorough Patient Assessment

The first step is to complete an initial assessment. This should include:

• Analyze the patient’s condition fully.
• Determine what their requirements are.
• Is the patient breathing?
• Is the patient responsive?

Use this information to move through the diagnosis and treatment stages of basic life support. It enables you to determine the person’s needs so that proper treatment can be set.

Consider Other Maneuvers

Other strategies can be applied to further improve outcomes. For example, you can combine the jaw thrust maneuver with other airway management methods, which can improve airway patency. There are two considerations:

a. Head tilt chin lift combination: 

This method allows both the jaw thrust and head tilt chin lift to be used at the same time. In some situations, the jaw thrust method is not enough to clear the airway. The use of a gentle, soft head tilt may improve this considerably. It still offers some level of protection for the cervical spine.

b. Bag-valve-mask ventilation: 

In this method, the technique is used on people who have a reduced level of consciousness and a blocked airway. It combines the bag valve mask ventilation method with the jaw thrust method.

Modified Jaw Thrust Maneuver

Another important factor to consider is the modified jaw thrust maneuver. Studies indicate that the modified jaw thrust maneuver can offer a variety of benefits to the patient who is unable to breathe on their own. Various methods can be used, and that means that a modified jaw thrust can be applied in situations where conditions call for it.

The modified jaw thrust incorporates a simple and slight modification of where you place your hand but can play a significant role in the outcome. In this method, one hand supports the patient’s jaw in the manner noted above in the standard method. The other hand helps to maintain the head in a neutral position, which prevents the head from moving while the maneuver is occurring.

In some situations, this is a critical alteration of the standard method. If there is a strong suspicion of a cervical spinal injury, any amount of head movement can worsen the condition or lead to a fatal outcome. For that reason, this method enables the opening of the airway while still providing enhanced stability for the head.

When a cervical injury is present, it is critical to still get air moving to the lungs to sustain life. Neck or spine injuries require careful consideration of what needs to happen first. This modification makes it a bit easier to clear the patient’s airway while still minimizing the risk of worsening the trauma to the neck or spine. It further minimizes the head movement.

A Semi-Conscious Patient

In some situations, the modified jaw thrust maneuver may be helpful if a patient has a minimal amount of consciousness but is having trouble maintaining their airway. This may be due to significant jaw pain or muscle weakness. In these situations, the modification of the jaw thrust method will allow a rescuer to improve the airway function while not causing significant discomfort or movement of the head in the process.

When the Jaw Thrust Maneuver Will Not Work

Opening a person’s airway is critical and not something to put off, even for seconds. However, this particular method may not be effective in situations like the following:

1. Fractures to the jaw:

This maneuver may cause extensive pain or may lead to a worsening of the injuries. If there are noted jaw injuries, healthcare professionals may need to consider alternative methods of airway improvement. This may include nasopharyngeal or oropharyngeal airways. Learn more about these in the basic airway adjuncts training we offer.

2. Lack of jaw mobility: 

In situations where there is a medical condition that makes it impossible to move the jaw, this method of opening the airway may not be possible. The use of a laryngeal mask airway or an endotracheal intubation method may be options.

3. Tracheostomy patients:

If the person has a tracheostomy, they have an alternative airway. The jaw thrust method is not suitable for these patients.

4. Neuromuscular disorders:

A person who has a condition like muscular dystrophy may not have much control over their jaw movements. This makes the jaw thrust method harder to perform and less likely to work to your specific needs.

5. Maxillofacial surgery patients:

A person who has undergone any type of maxillofacial surgery and has sutures or dressings present may not benefit from this type of airway management.

Mastering Basic Life Support is Your Objective

Understanding and effectively applying airway management techniques like the jaw thrust maneuver is essential for rescuers and healthcare professionals. This skill not only opens the airway to restore breathing but also ensures spinal stability, making it a critical method in trauma situations.

Knowing how to provide help to those who need it the most is critical. As a rescuer, you can prepare to do that by turning to certification. Learn the differences between BCLS and BLS certification, and then get started with us.

Learn more about our BLS Certification and Recertification programs and how well they can work to meet your needs.