The tongue falling backwards and blocking the nasopharynx is the commonest cause of upper airway obstruction. However, it may be due to blood, vomit, oedema, or trauma. The mouth should be inspected and any foreign material removed manually or by suction.

There are three manoeuvres to improve upper airway obstruction.

1. Head tilt. The neck is extended as far as possible using one hand.

2. Chin lift. The centre of the chin is pulled forward using the other hand.

3. Jaw thrust. The angle of the jaw is located. The index and other fingers are placed on both sides, between the angle of the jaw and the ear, and the jaw pulled forward (fig 1).

There is always a worry about manipulation …