Chin-Lift Manoeuvre

Unconscious patients lying supine are vulnerable to airway obstruction because the oral axis (OA), pharyngeal axis (PA) and laryngeal axis (LA) are misaligned (Fig 3).

Placement of a pillow or folded blanket beneath the head flexes the neck in relation to the torso (Fig 4).

A chin-lift manoeuvre extends the head in relation to the neck and achieves the sniffing position (Fig 5).

Both manoeuvres in combination improve axes alignment. If the patient is breathing adequately, a high-flow oxygen mask can be applied.

Fig 3

Malalignment of the oral, pharyngeal and laryngeal axes in a patient in the supine position.

Fig 4

Malalignment of the oral, pharyngeal and laryngeal axes in a patient in the supine position, and modification of alignment of axes, following placement of a pillow or folded blanket beneath the head.

Fig 5

Learning Bite

Beware hyperextension of the neck with the chin-lift manoeuvre because it can further compromise the airway.

Gentle movement is advised in patients with fixed neck deformities.