A JED, or Jaw Elevation Device, is a medical tool that keeps a sedated patient’s airway open by holding the lower jaw in a forward position. It’s an external, non-invasive device that straps around the head and lifts the jaw, preventing the tongue and soft tissues from collapsing backward and blocking the throat during deep sedation or anesthesia.
How the JED Works
When you’re deeply sedated, the muscles in your jaw and throat relax. That relaxation lets your tongue and the surrounding soft tissue slide backward, narrowing or completely blocking the airway. Normally, a member of the medical team would physically hold your jaw forward with their hands, a technique called a “jaw thrust.” The JED does this job mechanically.
The device consists of a head support, two adjustable arms, and a pair of single-use mandible cups (one for each side of the jaw). The cups cradle the lower jaw and the arms hold it in a lifted, forward position, mimicking the manual jaw thrust but without requiring anyone to stand there and maintain it. This creates what clinicians call a “hands-free” environment, freeing medical personnel to focus on the procedure itself.
Where It’s Used
The JED is designed for situations where a patient needs deep sedation but doesn’t necessarily need a breathing tube placed into the airway. One well-studied example is transcatheter aortic valve replacement (TAVR), a heart valve procedure performed under heavy sedation. During TAVR, the anesthesia team juggles multiple complex tasks at once, so having a device that independently keeps the airway open adds a meaningful layer of safety.
Beyond cardiac procedures, the JED is used during other invasive examinations and treatments that rely on intravenous sedation. It also has a secondary benefit: it can improve the view of the vocal cords during nasal fiberoptic intubation, making it useful as a positioning aid even when a breathing tube is eventually needed.
How Well It Performs
Clinical studies show the JED is significantly more effective than leaving the airway unmanaged during deep sedation. In a study of 46 patients undergoing TAVR, those fitted with the JED had almost no airway obstruction at the most critical point of the procedure, scoring a median of 0 on a 0-to-4 obstruction scale. Patients without the device scored a median of 3, meaning their airways repeatedly blocked and required manual jaw thrusts to reopen. None of the patients using the JED needed manual intervention.
A separate comparison tested the JED against a nasopharyngeal airway, a soft rubber tube inserted through the nose to keep the airway open. The JED group maintained significantly better breathing volumes during anesthesia. Specifically, patients with the JED lost less of their normal breathing volume than those using either the nasal airway or no device at all, suggesting the JED keeps the airway more consistently open.
JED vs. Traditional Airway Tools
Standard alternatives for managing the airway during sedation include oral airways (plastic devices placed inside the mouth), nasal airways (tubes inserted through the nostril), and manual jaw thrust performed by a clinician. Each has trade-offs.
- Oral and nasal airways are inserted into the body, which can trigger gagging, nosebleeds, or discomfort. The JED sits entirely outside the body, touching only the skin under the jaw and around the head.
- Manual jaw thrust works well but ties up a pair of hands for the entire procedure. During long or complex surgeries, this becomes a staffing burden and a potential safety issue if the clinician’s attention is pulled elsewhere.
- Breathing tubes (endotracheal intubation) are the most secure airway option but require deeper anesthesia, carry their own risks, and aren’t always necessary for procedures that can be done under sedation alone.
The JED fills a gap between doing nothing and placing something inside the patient’s airway. It provides reliable, continuous jaw support without the invasiveness of internal devices or the personnel demands of manual techniques. For procedures where deep sedation is preferred over full general anesthesia, it offers a practical middle ground that keeps breathing stable while the medical team focuses on the task at hand.