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May 20, 1961

AIRWAY PATENCY AND RESUSCITATION

JAMA. 1961;176(7):608-609. doi:10.1001/jama.1961.03040200044014

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Abstract

The head-tilt maneuver was reported in JAMA, Feb. 20, 1960, as a simple reliable method to prevent upper airway obstruction—particularly during mouth-to-mouth or mouth-to-nose breathing. In this issue of The Journal, this hyperextension maneuver is further recommended after x-ray studies of the behavior of the upper airway (page 570) and of mouth-to-nose respiration for cyanotic convulsive victims (page 565).

Although extension of the neck has long been used as a favorable position to minimize obstruction, the more reliable effects of hyperextension are not generally recognized. The head-tilt method lifts the tongue and soft palate well off the pharyngeal wall and separates the lips, providing a wide-open airway from lungs to nostrils and lips. The resulting patency of the pharynx is equal or greater than that achieved by the Heiberg-Esmarch maneuver, lifting of the mandibular rami or lifting of the lower jaw with the thumb. Unlike forward displacement of the mandible,

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