The importance of maintaining the infant airway cannot be over emphasized. Nearly every problem that the infant will have begins and ends with the airway. In order to properly manage the airway, you must first assess and possibly open the airway. Take immediate action to clear the infant’s airway if occluded. Provide positive pressure ventilation to the infant with absent or inadequate respirations. Provide aggressive oxygenation to infants in distress. Aggressive airway and breathing are modalities that greatly benefit the infant patient in distress.
Hopefully, you will hear the infant cry. The annoying sound should really come as a relief because at least you know that your patient will probably not require that much in the way of airway, breathing and oxygenation. If the infant is not crying or otherwise making any noise, then you start from the top. Place the patient in the supine position ensuring the neck is in a neutral position. If trauma is not suspected, then open the airway with the head-tilt-chin-lift method (otherwise utilize the modified jaw thrust unless the modified jaw thrust will not open the airway). The head tilt chin lift is performed in a similar manner as the adult, only the infant assumes the ‘sniffing’ position (which is to say with the nose tilted slightly toward the top of the head). It is important to ensure that you do not hyperextend the neck as you would in an adult. In lieu of hyper-extending the neck, place padding underneath the shoulders to balance out the effect of the patient’s huge head. The jaw thrust is performed by pulling the jaw forward with your fingers while pressing down on the cheek bone. The jaw thrust is not always the most efficacious way to open an airway, which is why if the airway can’t be opened in this manner, the head tilt chin lift method should be utilized.