Potential complication of inserting an oropharyngeal airway that is too small
An oropharyngeal airway (also known as an oral airway, OPA or Guedel pattern airway) is a medical device called an airway adjunct used in airway management to maintain or open a patient's airway. It does this by preventing the tongue from covering the epiglottis, which could prevent the person from breathing. When a person becomes unconscious, the muscles in their jaw relax and allow the tongue to obstruct the airway. Show
History and usage[edit]The oropharyngeal airway was designed by Arthur Guedel. Oropharyngeal airways come in a variety of sizes, from infant to adult, and are used commonly in pre-hospital emergency care and for short term airway management post anaesthetic or when manual methods are inadequate to maintain an open airway. This piece of equipment is utilized by certified first responders, emergency medical technicians, paramedics and other health professionals when tracheal intubation is either not available, not advisable or the problem is of short term duration.[citation needed] Oropharyngeal airways are indicated only in unconscious people, because of the likelihood that the device would stimulate a gag reflex in conscious or semi-conscious persons. This could result in vomit and potentially lead to an obstructed airway. Nasopharyngeal airways are mostly used instead as they do not stimulate a gag reflex. In general, oropharyngeal airways need to be sized and inserted correctly to maximize effectiveness and minimize possible complications, such as oral trauma. Insertion[edit]OP airways in varying sizes The correct size OPA is chosen by measuring from the first incisors to the angle of the jaw. The airway is then inserted into the person's mouth upside down. Once contact is made with the back of the throat, the airway is rotated 180 degrees, allowing for easy insertion, and assuring that the tongue is secured. An alternative method for insertion, the method that is recommended for OPA use in children and infants, involves holding the tongue forward with a tongue depressor and inserting the airway right side up. The device is removed when the person regains swallow reflex and can protect their own airway, or it is substituted for an advanced airway. It is removed simply by pulling on it without rotation. Use of an OPA does not remove the need for the recovery position and ongoing assessment of the airway and it does not prevent obstruction by liquids (blood, saliva, food, cerebrospinal fluid) or the closing of the glottis. It can, however, facilitate ventilation during CPR (cardiopulmonary resuscitation) and for persons with a large tongue. Oropharyngeal airways are rigid intraoral devices that conform to the tongue and displace it away from the posterior pharyngeal wall, thereby restoring pharyngeal airway patency. (See also Airway Establishment and Control Airway Establishment and Control Airway management consists of Clearing the upper airway Maintaining an open air passage with a mechanical device Sometimes assisting respirations (See also Overview of Respiratory Arrest.) read more , How To Do Head Tilt–Chin Lift and Jaw-Thrust Maneuvers How To Do Head Tilt–Chin Lift and Jaw-Thrust Maneuvers Part of pre-intubation and emergency rescue breathing procedures, the head tilt–chin lift maneuver and the jaw-thrust maneuver are 2 noninvasive, manual means to help restore upper airway patency... read more , and How To Insert a Nasopharyngeal Airway How To Insert a Nasopharyngeal Airway Nasopharyngeal airways are flexible tubes with one end flared (hence their synonym: nasal trumpets) and the other end beveled that are inserted, beveled end first, through the nares into the... read more .) Pharyngeal airways (both oropharyngeal and nasopharyngeal) are a component of preliminary upper airway management for patients with apnea or severe ventilatory failure, which also includes
The goal of all of these methods is to relieve upper airway obstruction caused by a relaxed tongue lying on the posterior pharyngeal wall. Indications for Oropharyngeal AirwayOropharyngeal airways are indicated for unconscious patients in the setting of
Contraindications for Oropharyngeal AirwayAbsolute contraindications
Relative contraindications Insertion of an oropharyngeal airway may not be feasible in some settings, such as
Nasopharyngeal airways may be used instead. Complications of Oropharyngeal Airway
Equipment for Oropharyngeal Airway
Additional Considerations for Oropharyngeal Airway
Relevant Anatomy for Oropharyngeal Airway
Positioning for Oropharyngeal AirwayThe sniffing position—only in the absence of cervical spine injury:
If cervical spine injury is a possibility:
Head and neck positioning to open the airway: Sniffing positionA: The head is flat on the stretcher; the airway is constricted. B: The ear and sternal notch are aligned, with the face parallel to the ceiling (in the sniffing position), opening the airway. Adapted from Levitan RM, Kinkle WC: The Airway Cam Pocket Guide to Intubation, ed. 2. Wayne (PA), Airway Cam Technologies, 2007. Step-by-Step Description of Oropharyngeal Airway Procedure
How To Insert an Oropharyngeal Airway VIDEO Aftercare for Oropharyngeal Airway
Warnings and Common Errors for Oropharyngeal Airway
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