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An oropharyngeal airway, a key component in BLS training, is a device used during CPR to prevent airway obstruction by keeping the tongue away from the throat. Its easy insertion helps optimize ventilation, thereby enhancing the chances of successful resuscitation
Utilize a sizing guide or ruler to measure the distance from the corner of the patient's mouth to the angle of the jaw. This measurement will help determine the appropriate size of the oropharyngeal airway.
Choose the correct size of the oropharyngeal airway based on the measured distance. Pediatric sizes are often color-coded for quick identification.
Ensuring proper sizing of oropharyngeal airways is vital for maximizing effectiveness and minimizing complications. The approach to sizing varies across age groups, accounting for anatomical differences and specific patient requirements:
Lilt the patient's head backward by placing one hand on the patient's forehead and gently lifting the chin with the other hand. This action helps to align the oral and pharyngeal axes, facilitating easier insertion.
Using the thumb and index finger, gently lift the patient's chin upward to create a sniffing position. This position optimizes the alignment of the airway for successful insertion.
Oropharyngeal airways are essential in BLS, particularly for unconscious patients, forming a vital part of initial airway management steps. Here are the key indications for using an oropharyngeal airway:
Knowing when to use an oropharyngeal airway is essential for healthcare providers and first responders, as this device plays a critical role in maintaining a clear airway in specific emergency situations.
Despite their usefulness in airway management, oropharyngeal airways are unsuitable in certain conditions and scenarios. Here are scenarios in which it is advisable to avoid the use of oropharyngeal airways:
Recognizing these contraindications is crucial to prevent potential complications.
The oropharyngeal airway is important in Basic Life Support (BLS) because it helps maintain a clear and open airway in unconscious or unresponsive patients. By preventing the tongue from obstructing the airway, the oropharyngeal airway facilitates effective ventilation during cardiopulmonary resuscitation (CPR). This simple yet crucial device aids in the delivery of rescue breaths, allowing BLS providers to support oxygenation and ventilation, essential components of the life-saving measures performed during cardiac emergencies.
The oropharyngeal airway is inserted through the mouth and sits in the oropharynx, preventing tongue obstruction. In contrast, the nasopharyngeal airway is inserted through the nose and sits in the nasopharynx, suitable when oral insertion is challenging. Endotracheal tubes are advanced through the mouth or nose into the trachea, securing an airway directly to the lungs, commonly used in advanced airway management.
A recent study compared the effects of inserting airways in the throat (oropharyngeal) and nose (nasopharyngeal) during anesthesia in 24 patients needing a specific type of intubation. Results showed that there was a significant increase in blood pressure after nasopharyngeal airway insertion, while oropharyngeal insertion had no such effect.
The 3 different types of Oropharyngeal Airway are:
To determine the right size of an oropharyngeal airway for a specific patient, measure the distance from the corner of the patient's mouth to the angle of the jaw on the same side. Choose an oropharyngeal airway size that matches this measured distance. For pediatric patients, use age-appropriate formulas, color-coded guides, or pediatric-specific sizing tools. Regularly reassess the patient's condition and the suitability of the airway, and select the appropriate width to accommodate the patient's oral anatomy without causing trauma. Use disposable sizing guides, pre-packaged kits, or rulers for accurate measurement.
Incorrect insertion of an oropharyngeal airway leads to various complications, including:
Healthcare providers must adhere to proper sizing, insertion techniques, and patient assessment to minimize the risk of complications associated with oropharyngeal airway use. Regular training and ongoing education are essential to maintain proficiency in airway management and enhance patient safety.
Here are some of the most common misconceptions about using oropharyngeal airways:
Addressing these common misconceptions is crucial for safely and effectively using oropharyngeal airways in clinical settings.
Recent advancements in the design and application of oropharyngeal airways have enhanced patient outcomes. Technological innovations have led to the development of airways with enhanced features, such as anatomically shaped designs that better conform to the natural contours of the airway. These advances aim to reduce the risk of complications associated with traditional oropharyngeal airways, such as soft tissue trauma or airway obstruction.
Additionally, there has been an increased emphasis on the importance of proper sizing and patient assessment to ensure the optimal selection of airways for different age groups. Training and educational programs for healthcare providers have also evolved to incorporate the latest evidence-based practices, enhancing proficiency in oropharyngeal airway insertion techniques.
Sources:
National Institutes of Health (NIH) - PubMed
American Journal of Emergency Medicine
Cardiovascular changes following insertion of oropharyngeal and nasopharyngeal airways - PubMed