This manoeuvre reduces the risk of airway obstruction in the unconscious or unresponsive casualty. The procedure allows lifting of the jaw, moving the tongue away from the throat.
Head tilt/chin lift
• Open the casualty's airway with a head tilt/chin lift (see Figure 5.1).
• Place one of your hands on the casualty's forehead.
• Remove any visible debris from the mouth with your finger, but leave well-fitting dentures in place.
• With the tips of the index and middle fingers of your other hand on the hard palate (the bony prominence of the chin) lift the chin to open the airway.
• In suspected cervical spine injuries, care must be used when opening the airway, with the jaw thrust being preferred (see Figure 5.2).
• You should place both hands on either side of the casualty's head, whilst resting your elbows on the surface behind.
• The angle of the jaw beneath the ear is held and lifted, without tilting the head.
• The lower lip can be moved down if the lips are closed.
Look, listen and feel for breathing
Bringing the side of your face above that of the casualty, you should:
• look for signs of chest movement;
• listen for breath sounds;
• feel for breath on the side of your face.
This manoeuvre should be completed in no more than 10
seconds (see Figure 5.3). If the casualty is breathing normally:
• employ the recovery position (see page 82 for a fuller explanation of this);
• continue to check for breathing signs, using the look, listen and feel manoeuvre;
• send someone else to summon help if you can, and ask them to report back to you;
• if alone, leave the casualty to summon help and return to the casualty as quickly as possible.
If the breathing is absent or severely impaired with only occasional gasps seen:
• send someone else to call for emergency help if you can, and ask them to report back to you;
• if alone, leave the casualty to call for emergency help and return as quickly as possible to start rescue breathing.
In specific cases, where unconsciousness might be the result of breathing problems, the rescuer is advised to complete one minute of CPR. Such cases include:
• drug- or alcohol-induced unconsciousness;
See Chapters 11, 13 and 14 for a fuller explanation of specific cases.
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