First Responder EMS Curriculum for Training Centers in Eurasia

Open the AirwayThe most common cause of airway obstruction in the unresponsive pediatric victim is the tongue.Therefore, once the child is found to be unresponsive, open the airway using a maneuverdesigned to lift the tongue away from the back of the pharynx, creating an open airway.Head Tilt-Chin Lift ManeuverIf the victim is unresponsive and trauma is not suspected, open the child's airway by tilting thehead back and lifting the chin. Place one hand on the child's forehead and gently tilt the headback. At the same time place the fingertips of your other hand on the bony part of the child'slower jaw, near the point of the chin, and lift the chin to open the airway. Do not push on the softtissues under the chin as this may block the airway. If injury to the head or neck is suspected, usethe jaw-thrust maneuver to open the airway; do not use the head tilt-chin lift maneuver.Figure 25. Head tilt-chin lift for childvictim.Jaw-Thrust ManeuverIf head or neck injury is suspected, use only the jaw-thrust method of opening the airway. Place 2or 3 fingers under each side of the lower jaw at its angle, and lift the jaw upward and outward.Your elbows may rest on the surface on which the victim is lying. If a second rescuer is present,that rescuer should immobilize the cervical spine (see "BLS in Trauma" below) after the EMSsystem is activated.Figure 26. Jaw thrust for child victim.Foreign-Body Airway ObstructionIf the victim becomes unresponsive with an FBAO or if an FBAO is suspected, open the airwaywide and look for an object in the pharynx. If an object is present, remove it carefully (undervision). Healthcare providers should perform a tongue-jaw lift to look for obstructing objects (seenext section), but this maneuver will not be taught to lay rescuers.Techniques for Healthcare ProvidersHypoxia and respiratory arrest may cause or contribute to acute deterioration andcardiopulmonary arrest. Thus, maintenance of a patent airway and support of adequateventilation are essential. Both the head tilt-chin lift and jaw-thrust techniques should be taught tolay rescuers. Healthcare providers should also learn additional maneuvers, such as the tongue-First Responder EMS Curriculum/AIHA, July 2002 351