For a drowning child with no spinal injury, how should you open the airway?

• A. Jaw thrust
• B. Hyperextension
• C. Mouth-to-mouth only
• D. Head tilt, chin lift

Answer: (D)

Open the airway with a gentle head tilt and chin lift. This position moves the tongue away from the back of the throat and straightens the airway so air can flow in and out readily. In a child with no suspected spinal injury, this is the quickest and most effective way to open the airway.

The jaw thrust would be used only if you suspect a cervical spine injury, because it minimizes neck movement but does not provide as reliable an airway opening in the absence of injury. Hyperextension is not recommended in children, as it can strain the neck and worsen airway obstruction. Mouth-to-mouth ventilation requires an open airway, but the act of opening the airway is achieved with the head tilt–chin lift.