Tripodal Jaw Thrust technique

The Tripodal Jaw Thrust technique was introduced to offer better support and control on the mandible while performing mandibular jaw thrust movement.  The technique is indicated for hypoventilating or non-breathing patients who are experiencing respiratory depression.

With proper respiratory monitoring (i.e. pretracheal stethoscope and/or capnography) clinicians shall be able to detect respiratory depression before oxygen desaturation occurs.

The Tripodal Jaw Thrust technique has been introduced to clinicians as an immediate reaction to clinical situations where respiratory depression is suspected. The technique is implemented to advance the mandible forward, thus open the airway and facilitate patient’s breathing.

 

Description of the Tripodal Jaw Thrust technique:

 

Step 1: With one hand, you will be performing jaw thrust while with the other hand head tilt

maneuver. Keep the middle and index fingers straight and in a 90 degree angle from each other. The index and middle finger will support the lower ridge of the mandible (left and right side). Keep the thumb finger curved, the thumb finger will be utilized to retain the mandible from the lower anterior teeth and advance it forward.

Step 2: With one hand, perform head tilt maneuver. This will properly position the head tilted to facilitate ventilation.

Step 3: Place the middle and index fingers at the lower ridge of the mandible (right-left). This will provide adequate support and control of the mandibular movements. The place your thumb along the lingual aspect of the mandibular incisors. This grip will enable you to have complete control fo the mandibular movements.

Step 4: Advance the mandible forward. This will facilitate respiration. Keep in mind that this technique is applied for patients that have experienced respiratory depression and oversedation (within the definition and boundaries of minimal and/or moderate sedation). The muscles that control mandibular movements at this stage are typically relaxed, therefore, with moderate effort the mandible shall advance forward.

 

Application of the described technique typically results in patient resuming normal breathing, However, if patient becomes desaturated or if respiratory movements are not detected, then  proceed with the O.P.T.I.M.A.A.L. technique.

 

Dr. Proussaefs has been applying this technique for more than 10 years for every patient experiencing signs of respiratory depression. The Tripodal Jaw Thrust technique has been taught at the California Institute of Dental Education for more than 5 years, and it has been applied by clinicians who have followed Dr. Proussaefs courses in adult oral sedation

To schedule a dental procedure using the Tripodal Jaw Thrust Technique with Dr. Proussaefs, please call (805) 676-1063 or contact one of our previous alumni of the CIDE adult oral sedation certification course who have been implementing the Tripodal Jaw Thrust Technique:

Previous Alumni  of the CIDE adult oral sedation certification course who have been implementing the Tripodal Jaw Thrust  technique:

Kevin Chou DDS, general dentist, Bakersfield, CA

Anna Durkin, general dentist, San Marcos, CA

Sherwin Matian, DMD, general dentist, West Hollywood, CA

Sarah Bukhari DDS, MS, Board certified prosthodontist, Redlands, CA

Abdulaziz AlHelal, Board certified prosthodontist, Loma Linda, CA

Ali Jazayeri DDS, general dentist, Mission Viejo, CA

Jeremy Sewell DMD, Temecula, CA

Sergio Ocampo DDS, La Miranda, CA

Dara Kimia DMD, Granada Hills, CA

Laura Fathi DDS, general dentist, Thousand oaks, CA

Raedh Alhwadi DDS, Merced, CA

Norma Lantzsch DDS, Riverside, CA

John Magnis DDS, Diplomate, American Board of Oral Implantology, Oxnard, CA

Kathy Patmore DDS, endodontist, Sanat Barbara, CA

Warren Gerosa, general dentist, Los Angeles, CA

Pat Emigh DDS, general dentist, Long Beach, CA

Pedram Fakheri DDS, periodontist, Los Angeles, CA

Tom Lim DDS, general dentist, Camarillo, CA

John Nerwinski DDS, general dentist, Las Vegas, NV

Jeffrey Rafaiski DDS, general dentist, El Cajon, CA

Irina Rodriguez, general dentist, Ojai, CA

Deven Rawlani DDS, general dentist, Pune, India

Suraj Sharma, general dentist, Riverside, CA


Spread the index and middle finger so they can support the inferior border of the mandible.

Bent the thumb finger which will be utilized to advance the mandible forward by holding the mandibular anterior teeth.

Place the index and middle fingers along the lower border of the mandible.

With the other hand, hold the patient’s forehead and perform a head-tilt maneuver

Frontal view. Use the index and middle fingers to support the mandible.


Place the thumb against the lingual aspect of the mandibular incisors. 


By using anterior force against the lingual aspect of the mandibular anterior teeth, advance the mandible forward.

The tripodal jaw thrust technique, an overview: Use the index, middle, and thumb fingers as a tripod to fully support the mandible while performing simultaneously jaw thrust and head tilt movements.


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