A two-handed airway maneuver of mandibular advancement and mouth opening in the neutral neck position for immobilization of the cervical spine

Sawada, Atsushi; Ochiai, Gen; Yamakage, Michiaki

doi:10.1007/s00540-021-02981-1

Cited by 1 publication

(2 citation statements)

References 12 publications

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“…More recently, Sawada et al. studied the effect of a two‐handed jaw thrust on cervical vertebral movement in 20 non‐obese, healthy patients [18]. This technique resulted in no significant change in anterior movement and small changes in intervertebral angulation (mean (SD) 3.2° (3.0°)) at C0–C4.…”

Section: Resultsmentioning

confidence: 99%

“…Historical data suggest that this may be contributed to by head tilt and chin lift positioning used to open the airway [17]. More recently, Sawada et al studied the effect of a two-handed jaw thrust on cervical vertebral movement in 20 non-obese, healthy patients [18]. This technique resulted in no significant change in anterior movement and small changes in intervertebral angulation (mean (SD) 3.2°(3.0°))…”

Section: Pre-oxygenation and Facemask Ventilationmentioning

confidence: 99%

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Airway management in patients with suspected or confirmed cervical spine injury

Wiles,

Iliff,

Brooks

et al. 2024

Anaesthesia

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SummaryBackgroundThere are concerns that airway management in patients with suspected or confirmed cervical spine injury may exacerbate an existing neurological deficit, cause a new spinal cord injury or be hazardous due to precautions to avoid neurological injury. However, there are no evidence‐based guidelines for practicing clinicians to support safe and effective airway management in this setting.MethodsAn expert multidisciplinary, multi‐society working party conducted a systematic review of contemporary literature (January 2012–June 2022), followed by a three‐round Delphi process to produce guidelines to improve airway management for patients with suspected or confirmed cervical spine injury.ResultsWe included 67 articles in the systematic review, and successfully agreed 23 recommendations. Evidence supporting recommendations was generally modest, and only one moderate and two strong recommendations were made. Overall, recommendations highlight key principles and techniques for pre‐oxygenation and facemask ventilation; supraglottic airway device use; tracheal intubation; adjuncts during tracheal intubation; cricoid force and external laryngeal manipulation; emergency front‐of‐neck airway access; awake tracheal intubation; and cervical spine immobilisation. We also signpost to recommendations on pre‐hospital care, military settings and principles in human factors.ConclusionsIt is hoped that the pragmatic approach to airway management made within these guidelines will improve the safety and efficacy of airway management in adult patients with suspected or confirmed cervical spine injury.

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Section: Resultsmentioning

confidence: 99%

Section: Pre-oxygenation and Facemask Ventilationmentioning

confidence: 99%