Certified Post Anesthesia Nurse (CPAN) Practice Exam

In the PACU, after a hernia repair, how can the airway obstruction caused by the tongue in a 3-month-old be alleviated?

1. Removing the pacifier

2. Pinching the cheeks

3. Turning him on his back

4. Using jaw thrust or chin lift

The correct answer is: Using jaw thrust or chin lift

In the context of a 3-month-old patient experiencing airway obstruction due to the tongue following a hernia repair in the Post Anesthesia Care Unit (PACU), the most effective method to alleviate the obstruction involves using a jaw thrust or chin lift maneuver. This technique is specifically designed to open the airway by repositioning the structures of the mouth and throat. In infants, the anatomy and muscle tone differ significantly from that of older children and adults. The tongue is relatively larger in proportion to the oral cavity, and infants commonly exhibit a natural tendency for their tongues to fall back, particularly when they are in a supine position. The jaw thrust or chin lift is a manual maneuver that lifts the jaw forward, which helps to prevent the tongue from obstructing the airway. This is crucial in maintaining airflow and ensuring adequate oxygenation for the infant. Other options are less effective for this specific issue. For example, removing a pacifier might not directly address the cause of the airway obstruction, and while it can sometimes improve airway patency, it does not provide the targeted mechanical advantage needed in this scenario. Pinching the cheeks may prompt some movement in the oral cavity, but it is not a recommended technique for airway management. Finally, simply turning the infant on