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Jaw lift--a simple and effective method to open the airway in children
B Roth1, J Magnusson, I Johansson
1Department of Anaesthesiology and Intensive Care, University Hospital, Lund, Sweden.
Insights
The jaw lift (JL) maneuver is more effective than the standard head tilt-chin lift (HT-CL) for opening airways in children during resuscitation. JL is recommended when HT-CL proves insufficient, preventing ventilation errors.
Area of Science:
- Pediatric Resuscitation
- Airway Management
- Anesthesiology
Background:
- Effective airway management is crucial during pediatric resuscitation to prevent ventilation errors.
- Failure to open the airway can lead to ineffective ventilation and gastric distension in children.
Purpose of the Study:
- To compare the efficacy of the head tilt-chin lift (HT-CL) and jaw lift (JL) maneuvers in opening the airway in children.
- To determine which maneuver is more effective in unconscious children with spontaneous breathing efforts.
Main Methods:
- A study involving 50 children aged 1-9 years undergoing anesthesia.
- Randomized performance of HT-CL and JL maneuvers by nurse anesthetists.
- Blind assessment of airway patency and quality by an anesthesiologist based on breathing sounds.
Main Results:
- The standard HT-CL maneuver was insufficient in 12% of pediatric patients.
- The JL maneuver demonstrated superior effectiveness in opening airways compared to HT-CL.
- JL was particularly effective in children retaining spontaneous breathing efforts.
Conclusions:
- The jaw lift maneuver is a more effective method for opening the airway in unconscious children with spontaneous breathing.
- JL should be considered as an alternative when the standard HT-CL maneuver is insufficient during pediatric resuscitation.
Abstract:
Assessment of breathing during resuscitation of children is important. Misjudgement due to failure to open the airway may lead to mouth-to-mouth ventilation in unconscious children who have retained spontaneous breathing efforts, and might lead to completely ineffective ventilation with gastric distension. The efficiency of the standard head tilt-chin lift manoeuvre (HT-CL) and the jaw lift manoeuvre (JL) for opening of the airway in children was investigated. Fifty children between 1 and 9 years of age breathing spontaneously during deep anaesthesia were studied. Both manoeuvres were randomly performed in all children by nurse anaesthetists. The time for opening and the quality of the airway was determined by a blind folded anaesthesiologist listening to the breathing sounds. The standard HT-CL manoeuvre was insufficient in 12% of the children. JL was more effective than HT-CL in opening the airway in unconscious children who had retained attempts at spontaneous breathing. The JL manoeuvre may, therefore, be recommended in situations when the HT-CL manoeuvre is insufficient.