How should the airway of a casualty with suspected neck or spinal injury be opened?

The jaw thrust maneuver is the most appropriate method for opening the airway of a casualty with a suspected neck or spinal injury. This technique involves displacing the jaw forward without tilting the head backwards, which helps to maintain the alignment of the cervical spine. This is critical in cases where spinal injuries are suspected, as moving the head or neck can exacerbate any existing damage.

Using the jaw thrust maneuver minimizes movement of the cervical spine, thereby reducing the risk of additional injuries. It is an essential skill in Tactical Combat Casualty Care, especially under combat conditions where such injuries are more prevalent.

The head tilt-chin lift maneuver and standard airway positioning can potentially put additional stress on the neck or spinal area, which is why they are not recommended in these situations. Moreover, a modified BVM (Bag-Valve-Mask) approach may require head position changes that could jeopardize spinal alignment, making it unsuitable for casualties with suspected spinal injuries.