Basic Airway Manoeuvres – OSCE Guide

This basic airway manoeuvres guide provides a step-by-step approach to performing a head-tilt & chin-lift or jaw thrust in an OSCE setting. Basic airway manoeuvres may be assessed in an OSCE as an individual skill, in combination with other airway management skills or as part of an ABCDE assessment.

Indications

Basic airway manoeuvres relieve upper airway obstruction in patients with a reduced level of consciousness. The tongue and soft palate can obstruct the upper airway in patients with a reduced level of consciousness. 

These basic airway manoeuvres do not require equipment and are quick to perform. 

Indications of upper airway obstruction include:

• Snoring
• Gurgling noises
• Hypoxia
• No fogging of oxygen mask

Head-tilt & chin-lift

The head-tilt & chin-lift manoeuvre anteriorly lifts the tongue and soft tissues of the pharynx to open the airway. This manoeuvre should not be performed in a patient with a suspected spinal injury as it causes extension of the cervical spine.

To perform a head-tilt & chin-lift:

1. Place one hand on the patient’s forehead and the other under the chin.

2. Tilt the forehead back whilst lifting the chin forward to extend the neck.

Jaw thrust

The jaw thrust involves lifting the mandible to move the tongue and relieve upper airway obstruction. The jaw thrust can be used in patients with a suspected spinal injury, as it does not extend the cervical spine. 

To perform a jaw thrust:

1. Identify the angle of the mandible

2. Place two fingers under the angle of the mandible (on both sides) and anchor your thumbs on the patient’s cheeks

3. Lift the mandible forwards

To complete the procedure…

Continue to monitor the airway and deliver interventions as required (e.g. basic life support, ABCDE assessment).

Consider inserting an oropharyngeal or nasopharyngeal airway.