In pediatric airway management, what is the correct approach to head position for an airway assessment?

• A. Hyperextend the neck.
• B. Do not hyperextend the neck as it may collapse the trachea.
• C. Tilt head backwards only.
• D. Use jaw-thrust exclusively.

Answer: (B)

In pediatric airway assessment, keep the head in a neutral position to open the airway without risking obstruction. Children have more compliant airways and a relatively large occiput, so hyperextending the neck can push soft tissues into the airway or even collapse the trachea. A neutral position, sometimes with a small towel under the shoulders to counter the natural flexion from the large head, helps align the airway without causing obstruction. Tilting the head backward or relying solely on a jaw-thrust are not ideal head-position approaches for initial assessment—the former can worsen obstruction, and the jaw-thrust is a separate airway maneuver rather than a head-position strategy.