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.[1] History and usage[edit]The oropharyngeal airway was designed by Arthur Guedel.[2] 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.[1] 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.[1] Usage[edit]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. Key risks of use[edit]The main risks of its use are:[3]
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When would you not insert an oropharyngeal into a patient?The oropharyngeal airway is a rigid, plastic device that is designed to fit over the tongue and keep it from falling to the back of the throat. Oropharyngeal (OP) airways should only be used on unresponsive patients. OP airways should not be used if: The patient is conscious.
What is a contraindication to the use of an oropharyngeal airway quizlet?An oral airway is contraindicated in the awake or lightlyanesthetized patient-the patient may cough or develop laryngospasm during airway insertion iflaryngeal reflexes are intact.
In which type of patient should a oropharyngeal airway not be inserted?Warnings and Common Errors for Oropharyngeal Airway
Use an oropharyngeal airway only if the patient is unconscious or minimally responsive because it may stimulate gagging, which poses a risk of aspiration. Nasopharyngeal airways are preferred for obtunded patients with intact gag reflexes.
What is a contraindication for inserting a nasopharyngeal airway?Absolute contraindications for NPA and NT intubation include signs of basilar skull fractures, facial trauma, and disruption of the midface, nasopharynx or roof of the mouth.
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