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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