If jaw-thrust maneuver is unsuccessful, which step should you take next?

• A. Carefully perform the head tilt-chin lift maneuver.
• B. Tilt the head back while lifting up on the patient's neck.
• C. Suction the airway and reattempt the jaw-thrust maneuver.
• D. Try opening the airway by lifting up on the chin.

Answer: (A)

When opening an airway after the jaw-thrust doesn’t work, the next step is to switch to a head tilt-chin lift. This maneuver changes the airway geometry in a different way: tilting the head back lifts the base of the tongue away from the back of the throat, and lifting the chin brings the jaw forward to further open the airway. Together, they increase the space for air to pass into the trachea, making ventilation more likely.

To perform it, place one hand on the patient’s forehead to tilt the head back gently, and use the fingers of your other hand to lift the chin upward and forward. Do this with care to avoid excessive neck movement, and only use it if there isn’t a possibility of cervical spine injury; if spinal injury is suspected, you should maintain stabilization and consider alternative airway methods. This approach is typically the best immediate action when a jaw-thrust hasn’t achieved an open airway, allowing you to reattempt ventilation.