You open an airway by tilting the person’s head back and lifting their chin, a technique called the head-tilt chin-lift. This is the standard method recommended by the American Heart Association for both CPR and any situation where an unconscious person isn’t breathing normally. The entire maneuver takes seconds and requires no equipment.
When someone loses consciousness, the tongue and surrounding soft tissues relax and fall backward against the throat wall, physically blocking the passage of air. Every airway-opening technique works by pulling the tongue forward and away from the back of the throat.
The Head-Tilt Chin-Lift
This is the go-to technique for most situations. Place one hand on the person’s forehead and gently tilt the head back. With the fingertips of your other hand, lift the bony part of the chin upward. That’s it. The combination of tilting the head and lifting the chin pulls the base of the tongue off the back of the throat and opens the airway.
A few details matter. Only press on the bony part of the chin, not the soft tissue underneath it. Pushing into the soft area under the jaw can actually compress the airway and make things worse. Keep the mouth slightly open as you lift. If you see obvious material in the mouth (food, vomit), turn the person on their side and clear it before attempting to ventilate.
When You Suspect a Neck Injury
If the person may have injured their neck or spine, such as after a car crash, fall, or diving accident, the jaw-thrust maneuver is the safer alternative. It opens the airway without tilting the head, which reduces the risk of worsening a spinal injury.
Position yourself at the top of the person’s head. Place your palms on their temples and your fingers along the lower edges of the jawbone on both sides. Push the jaw upward with your fingers until the bottom teeth are higher than the top teeth. This lifts the tongue forward just like the head-tilt does, but the neck stays in a neutral position the entire time.
Here’s the critical exception: if the jaw thrust doesn’t clear the airway and you can’t get air in, go ahead and use the head-tilt chin-lift even with a suspected neck injury. The 2025 American Heart Association guidelines are clear on this point. A patent airway outweighs the risk of further spinal damage, especially in cardiac arrest. An airway that stays blocked is fatal. A possible spinal injury is a risk worth managing.
Opening an Infant’s Airway
Babies have proportionally larger heads than adults, which means their default resting position already flexes the neck forward and can block the airway. The correct position for an infant is called the “sniffing position,” a slight extension of the head as if the baby were sniffing the air. Think neutral to very slightly tilted back, not the full backward tilt you’d use on an adult.
Research using MRI imaging on newborns and young infants found that airway patency increases progressively with head-tilt angle, with greater than 95% probability of an open airway at a slight extension. Over-extending an infant’s head (tilting it too far back) actually collapses the soft, flexible airway and makes obstruction worse. A small rolled towel placed under the shoulders can help offset the large head and bring the airway into alignment.
Clearing a Choking Airway
When the airway is blocked by a foreign object rather than the tongue, the approach changes entirely. A conscious person who is choking and cannot cough, speak, or breathe needs abdominal thrusts (commonly called the Heimlich maneuver). Stand behind the person, place a fist just above the navel, and deliver firm inward-and-upward thrusts to force air out of the lungs and dislodge the object.
Two groups should receive chest thrusts instead of abdominal thrusts: people who are obese and women in late pregnancy. For chest thrusts, wrap your arms around the person’s chest from behind and compress the breastbone. Children under about 45 pounds should receive only moderate-pressure abdominal thrusts and back blows, alternating between the two.
Keeping the Airway Open After You Clear It
Opening the airway is not a one-time fix. If the person is unconscious but breathing, the recovery position uses gravity to keep the airway clear. Roll the person onto their side with their head angled slightly downward. This prevents the tongue from falling back and lets fluids like mucus, blood, or vomit drain out of the mouth rather than pooling in the throat.
Airway adjuncts, simple plastic devices carried in first aid kits and by emergency responders, can also help. An oropharyngeal airway (OPA) is a curved tube inserted into the mouth that holds the tongue away from the throat wall. It’s sized by measuring the distance from the front teeth to the angle of the jaw. A nasopharyngeal airway (NPA) goes through the nostril and achieves the same result. NPAs should never be used if there’s any sign of a skull base fracture or severe facial trauma, because the device could pass through damaged bone into the brain.
Both adjuncts create a physical channel between the tongue and the back of the throat, maintaining the opening you established manually. They don’t replace the head-tilt chin-lift. They supplement it so you can focus on rescue breathing or CPR without the airway closing again each time you reposition your hands.