AIRWAY PATENCY AND RESUSCITATION

The head-tilt maneuver was reported inJAMA, 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 ofThe 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). Althoughextensionof the neck has long been used as a favorable position to minimize obstruction, the more reliable effects ofhyperextensionare 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,