To ensure that the airway of an infant or small child is correctly positioned, you may have to:

• A. Tilt the head back sharply.
• B. Place a towel or folded sheet behind the shoulders.
• C. Elevate the chin with a thick towel under the neck.
• D. Remove the child’s clothing from the spine area.

Answer: (B)

In infants and small children, keeping the airway aligned with the trachea requires a neutral head and neck position rather than a deep tilt. The large infant head tends to cause the neck to flex when lying flat, which can narrow or block the airway. Placing a towel or folded sheet behind the shoulders raises the upper back and shoulders just enough to prevent the head from tipping back or curling into the chest, helping the airway stay open and the axes of the airway and trachea to line up for effective ventilation.

Tilting the head back sharply can overextend the neck and often worsens airway patency in small patients. Elevating the chin with a thick towel under the neck tends to push the head into a position that may overly extend or misalign the airway. Simply removing clothing from the spine area does not address the need to align the airway.