A jaw thrust is a manual technique used to open a person’s airway when they are unconscious or unresponsive. It works by pushing the lower jaw forward, which pulls the tongue away from the back of the throat and clears the passage for air. This maneuver is especially important when a neck or spinal injury is suspected, because it opens the airway without tilting or moving the head.
Why the Airway Gets Blocked
When someone loses consciousness, the muscles in the tongue and throat relax. The tongue, which is anchored to the lower jaw, falls backward under gravity and presses against the back of the throat. This effectively seals off the airway, making it impossible for air to reach the lungs even if the person is still trying to breathe. Soft tissues in the neck can compound the problem by collapsing inward.
In many situations, a simple head tilt and chin lift is enough to pull the tongue forward and restore airflow. But that technique involves extending the neck, which can be dangerous if the person has a spinal injury, particularly in the upper vertebrae near the skull. The jaw thrust solves this by moving the jaw forward while keeping the head and neck completely still.
How the Jaw Thrust Works
The maneuver physically displaces the lower jawbone (the mandible) forward and slightly downward. Because the tongue is attached to the inside of the jaw through a small U-shaped bone called the hyoid, pushing the jaw forward lifts the tongue away from the back of the throat. This creates space in the airway without requiring any movement of the head or neck.
To perform it, the rescuer positions themselves at the top of the person’s head, looking down toward their feet. They place their fingers behind the angles of the jaw on both sides, just below the ears, and push the jaw forward and upward. The thumbs can rest lightly on the cheekbones or chin for stability. The key movement is forward, not upward, lifting the entire lower jaw as if sliding it out from under the upper teeth.
It requires both hands, which is one reason it can be more challenging than a head tilt and chin lift. If you’re alone and also need to deliver rescue breaths or hold a mask in place, the positioning gets difficult. This is part of why the technique is primarily taught to trained rescuers and healthcare providers rather than to the general public for basic CPR.
When It’s Used
The jaw thrust is the preferred airway technique any time a neck injury is possible. The most common scenarios include car accidents, falls from a height, diving injuries, and any trauma involving the head or face. In these situations, moving the neck even slightly could worsen damage to the spinal cord, so keeping the head in a neutral position is critical.
Research comparing the two main airway-opening techniques confirms that the jaw thrust produces significantly less movement in the upper spine, particularly at the junction between the first and second vertebrae, than a head tilt and chin lift. This is why the 2025 American Heart Association guidelines specifically recommend that trained rescuers use the jaw thrust when an unresponsive person has head or neck trauma.
That said, the guidelines also make a practical point: if a jaw thrust alone doesn’t open the airway and an airway adjunct (like a simple oral airway device) isn’t enough either, rescuers should switch to a head tilt and chin lift. Getting oxygen to the brain takes priority. A theoretical risk to the spine is less immediately dangerous than a completely blocked airway.
Jaw Thrust During Bag-Mask Ventilation
Beyond its role as a standalone technique, the jaw thrust is a core part of delivering breaths with a bag-valve mask, the squeezable bag connected to a face mask used in emergency rooms and by paramedics. Getting a tight seal between the mask and the face is notoriously tricky, and the jaw thrust helps in two ways: it opens the airway and it pushes the face up into the mask.
The AHA’s 2025 guidelines note that a two-handed mask technique with a jaw thrust is superior to the one-handed grip often called the E-C clamp. In this setup, one rescuer uses both hands to hold the mask and thrust the jaw forward while a second rescuer squeezes the bag. This two-person approach delivers more consistent breaths and maintains a better seal, which is why it’s the standard in professional resuscitation.
Why It’s Harder Than It Looks
The jaw thrust is a physically demanding technique. Pushing someone’s lower jaw forward against the resistance of relaxed muscles and tissue requires sustained force from the fingertips, and maintaining that force while also managing a mask or monitoring the patient is tiring. In practice, rescuers sometimes lose the jaw position after 30 seconds to a minute, especially if they’re working alone.
It’s also harder to learn correctly. The head tilt and chin lift is intuitive: tilt the head back, lift the chin. The jaw thrust requires precise finger placement behind the jaw angles and a specific forward direction of force that feels less natural. This is one reason CPR courses for laypeople focus on the head tilt and chin lift, while the jaw thrust is emphasized in professional-level training like Basic Life Support and Advanced Cardiac Life Support courses.
If you’re taking a CPR or first aid class, you’ll likely practice both techniques on a manikin. The jaw thrust is worth learning well, even if you hope never to use it. In any situation involving an unconscious person after a fall, collision, or blow to the head, it’s the safer way to open the airway and start getting air into the lungs.