Fitness

Head tilt chin lift: How to do it? Head tilt chin lift maneuver overview

head tilt chin lift

Head tilt chin lift: The patient who is asleep is likely to block their airway and die. The primary reason for this lies in the tongue. A patient who is asleep loses the entire tone of their muscles, including the tongue!

It is sometimes referred to (incorrectly) as “swallowing your tongue.” Instead, it blocks air from getting to the lungs and windpipe.

It is an emergency – without oxygen to the lungs, the patient could die within a matter of minutes.

head tilt chin lift maneuver can be employed to move the tongue to open the airway.

How to Perform a Head-tilt Chin-lift

  1. Kneel in front of the head of the patient
  2. Put one of your hands on the patient’s forehead and gently tilt the head to the side.
  3. Two fingers should be placed under the bony portion of their chins and raise the chin vertically.
  4. Be careful not to put anything pressure onto the soft side of the neck since it could block the airway.

After the airway has been open, you can check for breathing that is normal. The recovery posture (or the safe airway position) is when the patient is laid on their backs to ensure an open airway.

Description on Head tilt chin lift.

head tilt chin lift maneuver
BruceBlaus, CC BY-SA 4.0, via Wikimedia Commons

The head tilt chin lift maneuver is a method that is used to stop the tongue from blocking the upper airways, which is common in an unconscious or obtunded patient.

The head tilt chin lift technique is accomplished by moving the head backward for outpatients, usually by applying pressure to the forehead and chin.

The head tilt chin lift maneuver is utilized in all patients with a cervical spine injury that is not a problem and is taught in most First aid classes as a standard procedure for clearing an airway.

The head tilt chin-lift technique and the jaw-thrust process are among the primary methods of essential airway management.

The head tilting or shifting the neck is not advised when a patient has an injury to the cervical spine; however, keeping the airway and airflow open is more critical.

If there is an injury to the cervical spine, the jaw-thrust procedure where the neck is maintained in a neutral posture and the head is lowered is preferable to the lead tilt-chin-lift technique.

If cervical spine injuries are an option:

  • Put the patient in a supine position or with a slight angle onto the stretched.
  • Do not move the neck. Instead, practice the jaw-thrust technique first (before making the head tilt chin lift if necessary to widen your airway).

If the patient’s condition is at risk of inhaling, they should be placed in a recovery posture, or advanced management must be employed.

These are not common and can include:

  • Injury to the spinal cord if the cervical spine is injured by unstable ligamentous or bony injury
  • Mandibular injuries can be aggravated.

A step-by-step explanation of the head tilt chin lift technique.

Head tilt chin lift maneuver

  1. Kneel beside the head of the patient
  2. One hand ought to be placed on the patient’s forehead and gently tilt the head to the side.
  3. Set the points of the middle and index fingers beneath the bony area of their chins (not on muscles) and raise the chin upwards vertically. It helps lift the tongue away from the pharynx’s posterior part and increases airway health.
  4. Make sure not to put anything pressure onto the soft area of the neck because this may block the airway.

Make sure you make sure to only pull up on the bony areas of your mandible. In the case of pressure to the neck’s soft tissues can block the airway.

After the airway has been opened, it is possible to test for normal breathing. The recovery posture (or the safe airway position) is when the patient is placed on their back to keep an open airway.

Jaw thrusting maneuver

Place yourself at the top of the stretcher, rest your fingers on the patient’s temples, and place your fingers beneath the mandibular area.

If you are a patient with possible cervical spine injuries, stay away from stretching the neck.

The mandible should be lifted upwards using your fingers until the lower incisors are higher than the upper incisors. This action elevates the tongue in conjunction with the mandible, which relieves obstructions to the airway in the upper part of the body.

Make sure you press or pull up only on bony areas that make up the mandible. The cervical soft tissue can hinder the airway.

As part of pre-intubation and emergency breathing rescue procedures, The head tilt chin lift procedure and the jaw-thrust technique are two non-invasive, manual methods to restore the airway’s integrity when the glottis blocks the tongue.

It typically happens in an obtunded unconscious patient.

These techniques require continuous presence by the operator. Constitute integral to bag-valve-mask ventilation (BVM).

The patient’s proper position for sniffing whenever possible is an essential element of these manual procedures and aggressive methods for managing airways (i.e., supraglottic, tracheal, and artificial airways).

These techniques should be complemented by the use of oropharyngeal and nasal airways.

Continuous positive airway pressure can result in airway integrity when manual methods fail on their own.

Indications

  • Treatment of suspected airway obstruction in nonresponsive patients
  • The first step in emergency care for respiratory apnea and impending arrest
  • The improvement of airway patency is seen during BVM ventilation and, sometimes, when breathing spontaneously.
  • Confirmation of Apnea

Contraindications

Absolute contraindications

  • It is not a medical or medical-related reason for providing emergency breathing. However, patients may have a medical contraindication (do-not-resuscitate order or another advance directive in effect).

Contraindications to use:

  • Cervical spinal injury to the cervical spine

Moving the head in any way or shifting the neck is not advised for patients suffering from potential cervical spine injuries; however, keeping the airway and airflow open is the most important thing to do.

If there is an injury that could be cervical, the jaw-thrust technique where the neck is kept in a neutral position and the head is lowered is preferable to the lead tilt-chin-lift technique.

Complications

These are rare and may are not expected. They can

  • Spinal cord injury occurs when the cervical spine is injured by an unstable ligamentous or bony injury.
  • Exacerbation of mandibular trauma

Equipment

  • Mask, gloves, gown (i.e., all-encompassing precautions)
  • Sheets, towels, and commercial equipment (ramps) for lifting the head and neck to achieve optimal positions
  • Suctioning device and Yankauer catheter Magill forceps (if required to get rid of easily accessible foreign bodies and the patient is not gag-resistant) to cleanse the pharynx when needed

Additional Considerations

  • Suction is recommended when necessary to clean the upper airway.

Positioning

The sniffing posture is only applicable when there are no cervical spine injuries.

  • Place the patient onto the stretched.
  • Align the airways of your upper part to ensure optimal airflow by putting the patient in the correct position to sniff. A proper place for sniffing will align the auditory canal’s outer side with the sternal or notch.
    To attain the appropriate sniffing position and achieve adequate status, folded towels or other objects may need to be placed beneath the neck, head, or shoulders so that the neck is bent over the body and the head is positioned over the neck.
    For obese patients, many wrapped towels or even a ramp from a retail store might be needed to raise the neck and shoulders. For young children, padding is often required behind the shoulders to support the more prominent occiput.

If cervical spine injuries are an option, it is

  • Place the patient in a supine place or with a slight incline onto the stretched.
  • Do not move the neck. Instead, perform the jaw thrust first (before making the head tilt chin lift, if required to open your airway).

Relevant Anatomy

  • The alignment of the external auditory canal to the sternal bony notch could assist in opening the airway and create the ideal location to see the airway in case endotracheal intubation is required.
  • The level of head tilt that is most aligned with the sternal notch and ear differs (e.g., there is no difference for children who have large occiputs or a substantial amount for overweight patients).

Step-by-Step Description of Procedure

Head tilt chin lift

  • The patient’s head should be tilted back by pressing it against the forehead.
  • Put both the points of your middle and index fingers below your chin, and pull upwards on your mandible (not on soft tissue). It removes the tongue away from the pharynx posterior and increases airway health.
  • Make sure that you make sure to only pull up on the bony areas that make up the mandible. In the case of pressure to the cervical soft tissue can block the airway.

Jaw thrust

  • Place yourself at the top of the stretcher, rest your fingers on the patient’s temples, and place your fingers beneath the mandibular area.
  • For patients who may have a neck injury, be cautious about exaggerating the neck.
  • Mandibles should be lifted using your fingers, at a minimum, until the lower incisors are higher than the upper incisors. This action raises the tongue and the mandible, which relieves the obstruction of the upper airway.
  • Make sure you pull or push upwards only the bony portions of your mandible. The muscles of your neck could hinder the airway.

Aftercare

  • Continue to hold these positions until you are required to.
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