In obese patients, standard pillow placement may compromise the airway further by causing flexion of the head in relation to the neck.
To optimise an obese patient’s airway, place a pillow under their shoulders and a number of pillows under their head to elevate the chin above the chest (See Figure 6 & 7).
Fig 6: Chin-lift manoeuvre. Neutral position, malalignment of the axes. Obese patient | Fig 7: Chin-lift manoeuvre. ‘Sniffing’ position, improved alignment of the axes. Obese patient |