When attempting to create a more open airway, what is important to remember about neck position?

• A. Hyperextending the neck will always open the airway
• B. Flexing the neck beyond a point improves airway
• C. Hyperextending the neck does not open the airway past a certain point
• D. Turning the head to the side always guarantees airway patency

Answer: (C)

Opening an airway relies on aligning the airway axes, and a bit of neck extension helps with that alignment by moving the tongue and soft tissues away. However, there is a limit: extending the neck beyond the point that maximizes airway space does not continue to improve patency and can even narrow the airway or cause tissue collapse. So the important takeaway is to achieve an optimal, neutral or sniffing position rather than overextending. Excessive extension also carries risk to the cervical spine. Flexing the neck too much or turning the head to the side are not reliable ways to guarantee an open airway and can worsen patency.