Ventilation

Ventilation of the unconscious, or, in some circumstances conscious, patient has the following aims:

• clear and control the airway
• optimise ventilation
• use airway adjuncts effectively

Obstruction in the absence of trauma or a foreign body is caused by:

• tongue
• epiglottis

The airway is opened by stretching the anterior structures of the neck to lift the tongue away from the posterior wall of the hypopharynx. This is achieved by flexing the neck on the thorax and extending the head. In practise this involves tilting the head back and lifting the chin. Pressure should not be applied behind the neck.

The jaw thrust can also be used, where the hands are placed on the sides of mandible, levering against face to pull the jaw forward.

The possibility of cervical spine injury should always be considered, and in such cases, the neck should be handled with care and the airway maintained with only minimal head tilt.