Esmarch handle in adults

Carola Felchner is a freelance writer in the medical department and a certified training and nutrition advisor. She worked for various specialist magazines and online portals before becoming a freelance journalist in 2015. Before starting her internship, she studied translation and interpreting in Kempten and Munich.

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As a first aider, you can use the Esmarch handle to open the mouth of an unconscious person - if necessary by force, if the jaw muscles are cramped. Then you can see whether the mouth and throat are free or need to be cleared of a foreign body (for example vomit or the tongue that has fallen back). Find out here how the Esmarch handle is carried out exactly and what risks it entails.

Brief overview

• What is the Esmarch Handle? A special handle that a first responder uses to open the mouth of an unconscious person to clear or keep their mouth and throat free.
• This is how the Esmarch move works: Kneel behind the affected person, put your thumb on the chin, place the remaining fingers under the jawbone and then push the lower jaw forward and the chin down.
• In what cases? For unconscious, to free the mouth and throat of any foreign bodies or to place a breathing aid.
• Risks: With the classic Esmarch grip, the head of the person concerned is hyperextended backwards. This can damage the spinal cord in the case of cervical vertebrae injuries.

Caution!

• The correct Esmarch handle is difficult to learn. That is why laypeople are often only shown the life-saving handle in the first aid course (overstretching the head). In the event of a cervical vertebra injury, however, this can damage the spinal cord.
• In the event of (suspected) injuries to the cervical spine, the modified Esmarch handle is used. The head remains in a neutral (normal) position.
• Forcing your mouth open with this handle is exhausting and requires practice.
• If possible, wear disposable gloves when performing the Esmarch handle (as is generally the case with first aid measures).

How does the Esmarch handle work?

The Esmarch handle is named after the German surgeon Friedrich von Esmarch (1823-1908). It is used to open the mouth of an unconscious person and to clear or keep the mouth and throat free. The Esmarch handle is also necessary if you want to place various breathing aids.

Esmarch handle: that's how it works!

How to proceed with the classic Esmarch handle:

1. Lay the unconscious patient on their back, preferably on a flat, hard surface.
2. Kneel behind him, or more precisely: behind his head.
3. Slightly overstretch the patient's head backwards. Overstretching (also called a lifesaving handgrip) can make it easier to clear the airways.
4. Now place your thumbs on the chin of the unconscious person and the remaining fingers on both sides of the head under the jawbone, in the area of ​​the angle of the jaw. The ball of the thumb can be supported on the patient's cheekbones, but not too close to the eyes to avoid injuring the eyeball.
5. Now push the lower jaw forward with your fingers (i.e. the lower row of teeth in front of the upper row), which lifts the base of the tongue. In addition, press your chin down with your thumbs so that your mouth opens. The head of the person concerned should not be moved as much as possible.
6. Fix this position with one hand. With the other, you can now, if necessary, free the mouth and throat of the unconscious person from foreign bodies. If a cervical spine injury can be ruled out, you can turn the unconscious head on its side.

Modified Esmarch handle

With this variant, you basically proceed in the same way as with the classic Esmarch handle - but you refrain from overstretching the head of the person concerned! This "modified Esmarch handle" is used for (suspected) cervical spine injuries.

When do I do the Esmarch handle?

Use the Esmarch Handle to check an unconscious person to see if their airways are blocked and, if necessary, to clear the foreign body from their mouth and throat. In addition, the Esmarch handle is also necessary in order to place breathing aids or suction devices in an unconscious person.

The foreign object that can obstruct the airway is sometimes the tongue that has fallen back. When someone loses consciousness, the muscles of the tongue relax. There is then no longer a resting tone such as during sleep. If an unconscious person is lying on their back, the slack tongue can fall back into the throat and partially or completely block the airways.

If a person is no longer breathing, you must act immediately and start resuscitation! Without oxygen, the person affected can die after just a few minutes.

The Esmarch handle in children

In principle, the mouth of unconscious newborns, infants and small children can also be opened using the Esmarch handle. What you should pay attention to can be found in the article Esmarch handle in children.

Risks of the Esmarch Handle

Avoid stretching the unconscious head back too much (with the classic Esmarch grip)! Otherwise the airways will narrow or the distance between the base of the tongue and the back of the throat will be reduced. Blood vessels can also be constricted with this coated form of the Esmarch handle.

If you perform the classic Esmarch maneuver (with overstretching the head) for injuries to the cervical spine, you can damage the spinal cord.

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