Esmarch handle
The Esmarch handle (after Friedrich von Esmarch ; " Jaw thrust maneuver " according to ERC guidelines), also known as the head and jaw handle , is a measure that is used to clear and keep the airways of an unconscious person free . It is used in the context of airway management in emergency medicine and in anesthesia.
Since the skeletal muscles, including the tongue muscles, slacken when they become unconscious, breathing may be impeded in the unconscious person lying on their back : While the resting tone of the muscles normally keeps the tongue in the oral cavity , it sags when it is flaccid (if there is no muscle tension) following the force of gravity into the pharynx , where it can partially or completely obstruct the airways in the pharynx or the larynx entrance ( glossoptosis ).
In order to pull the base of the tongue with the lower jaw, which has also fallen backwards, forwards and thus free the airways again, the unconscious head is overstretched with the simple Esmarch handle ( life-saving handle ). The Esmarch handle modified by Peter Safar ( 3-in-1 handle according to Safar ) serves to intensify this effect by additionally pressing and lifting the lower jaw forward and opening the mouth. To do this, the helper, kneeling behind the unconscious, grips the lower jaw branches in the back area (jaw angle) with his fingers, while he exerts pressure on the chin surface with his thumbs in the front area. From this position the lower jaw can be pushed forward and up.
As part of the training of laypeople in first aid , the Esmarch handle is no longer taught because the cervical spine is subject to movements. After trauma , these movements could damage the spinal cord in the cervical spine. If the handle is performed without these movements of the cervical spine, this is called a modified Esmarch handle by some authors. This is used to secure the airway in patients with cervical spine (cervical spine) trauma without moving the cervical spine. This prevents possible damage to the spinal cord.
literature
- RW Koster, MA Baubin, LL Bossaert et al: European Resuscitation Council Guidelines for Resuscitation 2010: Section 2. Adult basic life support and use of automated external defibrillators. In: Resuscitation. 81 (10), Oct 2010, pp. 1277-1292. PMID 20956051 .
- Walied Abdulla: Interdisciplinary Intensive Care Medicine. Urban & Fischer, Munich a. a. 1999, ISBN 3-437-41410-0 , p. 5 f.
