How Do You Open the Airway for Breaths When a Single Rescuer Is Present?

The answer

For a single lay or professional rescuer giving rescue breaths, the standard way to open the airway is the head-tilt/chin-lift:

1. Place the heel of one hand on the victim's forehead and apply firm, backward pressure to tilt the head back.
2. Place the fingertips of your other hand under the bony part of the lower jaw, near the chin.
3. Lift the chin upward to bring the jaw forward.

Tilting the head and lifting the chin pulls the tongue away from the back of the throat. In an unresponsive person the tongue is the most common airway obstruction, so this simple movement opens the passage and lets your rescue breaths reach the lungs. Do not press deeply into the soft tissue under the chin (it can obstruct the airway) and do not fully close the mouth.

When to use the jaw-thrust instead

If you suspect a head, neck, or spinal injury (for example after a fall, diving accident, or car crash), tilting the head back could worsen a spinal cord injury. In that case a rescuer trained in the technique uses the jaw-thrust maneuver: position yourself at the top of the victim's head, place your fingers on the angles of the lower jaw on both sides, and lift the jaw forward without tilting the neck.

An important caveat from current CPR guidance: if the jaw-thrust does not open the airway, or you cannot perform it effectively, revert to the head-tilt/chin-lift, because an open airway is the priority. For a lone lay rescuer, guidelines generally teach the head-tilt/chin-lift for all victims to keep it simple, since maintaining ventilation matters most.

Fitting it into single-rescuer CPR

Opening the airway is one piece of the larger sequence. For a single rescuer performing adult CPR:

• Check the scene and the victim, call for help / activate EMS and get an AED.
• Give 30 chest compressions (rate 100 to 120 per minute, depth at least 2 inches).
• Open the airway with head-tilt/chin-lift and give 2 rescue breaths, each over about 1 second, watching for the chest to rise.
• Continue cycles of 30 compressions to 2 breaths until help or an AED arrives, or the person recovers.

The adult single-rescuer ratio is 30:2. (For infants and children with two rescuers it changes to 15:2, but a lone rescuer still uses 30:2.)

The bigger picture

Effective rescue breaths depend entirely on a properly opened airway, so this step is not optional busywork; a breath given without opening the airway simply inflates the stomach or goes nowhere. If breaths do not make the chest rise, re-tilt the head, re-lift the chin, and ensure a good seal before trying again, then return promptly to compressions to minimize interruptions.