To maintain neutral alignment of an 18-month-old child's airway, what should be done?

To maintain neutral alignment of an 18-month-old child's airway, placing padding in between the shoulder blades is an effective method. This approach helps to elevate the chest and facilitate proper positioning of the head and neck, ensuring that the airway remains open and unobstructed. In young children, their physiological features, such as a proportionally larger head and shorter neck, mean that achieving the right alignment is critical to preventing airway obstruction.

Using padding in this manner maintains a neutral position that accommodates the natural curvature of a child's spine, which is important for both comfort and safety. Having the head in a neutral position, with the chin not excessively tilted upward or downward, is crucial for optimal ventilation and reducing risk during any medical procedures that involve airway management.

The other options, such as hyperextending the head or slightly flexing it, can compromise the airway by either blocking it or creating an unfavorable angle for airflow. While a rolled towel under the head may seem like an alternative solution, it does not provide the same level of support that padding between the shoulder blades does, potentially risking the maintenance of an open airway.