Airway

Simple intervention, such as the chin lift without neck extension, jaw thrust, and oropharyngeal suctioning, often clears the airway. In mandibular fractures, however, loss of bony support may result in a flail mandible, leaving the tongue to obstruct the airway.6 In this case, open the mouth and pull the tongue forward with a gauze pad, towel clip, or a large suture placed through the anterior tongue. When the cervical spine has been cleared, clinically or radiographically, allow the patient to sit up and lean forward, and give the patient a tonsil-tip suction. This position may be lifesaving in patients with significant mandible fractures. Patients who do not respond to simple maneuvers may require intubation.

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