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A jaw thrust is a technique for securing the airway of a patient who may have a spinal injury; in such cases, care 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 qualified emergency services personnel and doctors perform the jaw thrust, as it is potentially dangerous for the patient. It may be used in the field and in settings like operating rooms to keep a patient's throat clear.
In a jaw thrust, the patient is supine, lying face up. The care provider places the hands on either side of the face, hooking the fingers under the end of the jaw, just below the ear. Next, the person pulls the jaw forward. This displaces the jaw, pushing the tongue forward as well, and keeps the throat clear. Otherwise, the tongue may fall back into the throat, obstructing the patient's airway and making it hard to breathe.
A patient with a potential spinal cord injury is a cause for concern. Moving the head and neck could exacerbate the injury and cause more damage. If the patient cannot breathe, however, the outlook is extremely grim. Techniques like the jaw thrust allow care providers to provide basic care with a minimum of risk to their patients. Other options include the head tilt and chin lift technique, taught widely in cardiopulmonary resuscitation classes so people know how to quickly open up a patient's airway in a reasonably safe way.
In anesthesiology, a care provider may consider using a jaw thrust on a patient to keep the tongue clear of the airway during surgery, depending on the situation and personal preference. Anesthesiologists must manage the airway carefully, as their patients cannot breathe on their own and could be at risk of complications if they do not get enough air. Having a library of methods to open up the airway and keep it clear is useful for a variety of situations.
In a patient who can breathe independently, the jaw thrust is not necessary. Maneuvers to open up the airway should only be considered if a patient is having difficulty breathing or does not appear to be breathing at all. The simple step of asking a patient questions and waiting for a response can determine whether the airway is clear; if the patient is talking, he can breathe.
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